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Did Medicaid Expansion Reduce Medical Divorce?

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  • David Slusky
  • Donna Ginther

Abstract

Medical divorce occurs when couples split up so that one spouse’s medical bills do not deplete the assets of the healthy spouse. It has not been studied in the economics literature, but it has been discussed by attorneys and widely reported in the media. We develop a model of medical divorce that demonstrates that divorce is optimal when a couple’s joint assets exceed the exempted asset level. We use the Affordable Care Act’s Medicaid expansion which removed asset tests to qualify for Medicaid as exogenous variation in the incidence of divorce (as it was only implemented by some states). We find that the ACA expansion decreased the prevalence of divorce by 11.6% among those ages 50–64 with a college degree. These results are robust to numerous placebo checks including older subsamples (who qualify for Medicare regardless of assets) and earlier years (before the expansion was implemented). Our results suggest that Medicaid expansion reduced medical divorce.

Suggested Citation

  • David Slusky & Donna Ginther, 2017. "Did Medicaid Expansion Reduce Medical Divorce?," NBER Working Papers 23139, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23139
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    1. Laura Connolly & Matt Hampton & Otto Lenhart, 2024. "Labor mobility and the Affordable Care Act: Heterogeneous impacts of the preexisting conditions provision," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 43(1), pages 157-191, January.
    2. Lindsey Rose Bullinger, 2021. "Child Support and the Affordable Care Act's Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(1), pages 42-77, January.
    3. Margaret Gough Courtney, 2023. "Did the Affordable Care Act’s Medicaid Expansion Change Cohabitation Trends?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(3), pages 1-26, June.
    4. Aparna Soni & Taryn Morrissey, 2022. "The effects of Medicaid expansion on home production and childcare," Southern Economic Journal, John Wiley & Sons, vol. 88(3), pages 931-950, January.
    5. Masanori Kuroki, 2021. "The effect of health insurance coverage on personal bankruptcy: evidence from the Medicaid expansion," Review of Economics of the Household, Springer, vol. 19(2), pages 429-451, June.
    6. Margaret E. Blume-Kohout, 2024. "Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act," ILR Review, Cornell University, ILR School, vol. 77(2), pages 199-226, March.
    7. Matt Hampton & Otto Lenhart, 2022. "The effect of the Affordable Care Act Medicaid expansion on marriage," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 568-591, April.

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    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J12 - Labor and Demographic Economics - - Demographic Economics - - - Marriage; Marital Dissolution; Family Structure

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