The effect of the Affordable Care Act Medicaid expansion on marriage

Hampton, Matt; Lenhart, Otto

doi:10.1111/ecin.13052

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…For example, after states raise their minimum wages, lower-income earners delay marriage and are less likely to divorce (Karney et al, 2022). After states expanded Medicaid coverage through the Affordable Care Act, residents in those states married at slightly lower rates and divorced at slightly higher rates, presumably because partners were less reliant on each other for health insurance (Hampton and Lenhart, 2022). The way in which states implemented welfare reform after the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 was passed had measurable (and unintended) negative effects on rates of marriage and divorce for women receiving benefits (Bitler et al, 2004;Pub.…”

Section: Discussionmentioning

confidence: 99%

Twenty Years of Legal Marriage for Same-Sex Couples in the United States: Evidence Review and New Analyses

2024

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Twenty years after the first marriage licenses were issued to same-sex couples in Massachusetts, this report provides a review of evidence and new analyses describing the effects of granting legal status to the marriages of same-sex couples in the United States. For the evidence review, we assembled and evaluated existing research that has examined how any form of legal status (e.g., marriage, civil unions, domestic partnerships) affects well-being in lesbian, gay, bisexual, and transgender individuals; their children; and the general public. For the new analyses, we leveraged data from multiple national datasets (e.g., the American Community Survey, the Current Population Survey, the Panel Study of Income Dynamics, the Monitoring the Future main study) to examine how changes in the legal status of same-sex couples within and across states affected trends in family formation (e.g., marriage and divorce) between 2000 (before marriage was available to same-sex couples in any state) and 2014 (when the last cohort of states chose to issue marriage licenses to same-sex couples before all restrictions on marriage for same-sex couples nationwide were lifted by Obergefell v. Hodges). This report should be of interest to researchers and policymakers considering how to promote the well-being of relationships, U.S. families, and members of gender and sexualminority groups. Preparation of this report was supported by Centerline Liberties, Inc., a 501(c)3 focused on advancing policy solutions that defend core constitutional freedoms and liberties. Social and Behavioral Policy ProgramRAND Social and Economic Well-Being is a division of RAND that seeks to actively improve the health and social and economic well-being of populations and communities throughout the world. This research was conducted in the Social and Behavioral Policy Program within RAND Social and Economic Well-Being. The program focuses on such topics as risk factors and prevention programs, social safety net programs and other social supports, poverty, aging, disability, child and youth health and well-being, and quality of life, as well as other policy concerns that are influenced by social and behavioral actions and systems that affect well-being. For more information, email

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Section: Discussionmentioning

confidence: 99%

Twenty Years of Legal Marriage for Same-Sex Couples in the United States: Evidence Review and New Analyses

2024

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“…Among college-educated Medicaid-eligible couples ages 50 to 64 in states that no longer require asset tests for eligibility, divorce rates appear to have decreased (Slusky and Ginther 2021). On the other hand, among individuals with high school or less education, the ACA’s Medicaid expansion is associated with a lower probability of becoming married and a higher probability of divorce (Hampton and Lenhart 2022). Given these demonstrated and varied impacts of the ACA on marriage, it is conceivable that other characteristics of married and unmarried individuals could systematically differ in the post-ACA period in some way relevant to the probability of self-employment among individuals in each group.…”

Section: Validating the Difference-in-differences Modeling Assumptionsmentioning

confidence: 99%

Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act

Blume-Kohout

2023

ILR Review

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Most US workers have health insurance plans sponsored and subsidized by their employers. The US Affordable Care Act (ACA) improved and expanded the availability of non-employer-based health insurance, with protections for pre-existing conditions, guaranteed issue, and community rating in non-group markets. Using National Health Interview Survey data for 2009 to 2018 and a difference-in-differences modeling approach, this study finds that the ACA increased self-employment in 2015 and 2016 among US adults with higher demand for health insurance. The probability of self-employment increased by 1.4 to 1.8 percentage points among adults ages 30 to 64 with at least one pre-ACA declinable condition and no alternative source of health insurance through a spouse’s employer or public programs. However, these effects were short-lived. As uncertainty about the long-term viability of the ACA’s health insurance exchanges increased in 2017 and 2018, the probability of self-employment among individuals with high demand for insurance fell to pre-ACA levels.

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“… See Campbell and Shore-Sheppard (2020) for an extensive overview of the financial and labor market effects of the ACA, including a notable absence of studies on the preexisting conditions provision.6 ACA Medicaid expansion also reduced the likelihood of marriage(Hampton & Lenhart, 2022b) and of medical divorce among those ages 50 to 64 with a college degree(Slusky & Ginther, 2021).…”

mentioning

confidence: 99%

Labor mobility and the Affordable Care Act: Heterogeneous impacts of the preexisting conditions provision

Connolly,

Hampton,

Lenhart

2023

J Policy Anal Manage

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The Patient Protection and Affordable Care Act (ACA) preexisting conditions provision ensures that insurance companies can no longer deny coverage, charge higher premiums, or exclude coverage due to a preexisting health condition. In this paper, we evaluate the impact of the provision on labor mobility. We use data from the Panel Study of Income Dynamics for years 2009 through 2019 and estimate difference‐in‐differences models to determine whether the provision improved labor mobility for individuals with chronic conditions. While females respond along the extensive margin by being less likely to work, males experience broader labor mobility improvements. Men are more likely to start a new job, become employed in a different industry, and move to a different state in the post‐policy period. Labor mobility improvements are largest among males with household incomes greater than 138% of the federal poverty level, males ages 35 to 49, and males with conditions first diagnosed more than 10 years ago. Last, we show that the policy improved access to health insurance coverage and reduced the likelihood that health impacts the amount or type of work, which ultimately increased labor market flexibility. Our results highlight the heterogenous impacts of the provision on different subgroups of the population.

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The effect of the Affordable Care Act Medicaid expansion on marriage

Cited by 9 publications

References 27 publications

Twenty Years of Legal Marriage for Same-Sex Couples in the United States: Evidence Review and New Analyses

Twenty Years of Legal Marriage for Same-Sex Couples in the United States: Evidence Review and New Analyses

Entrepreneurship Lock and the Demand for Health Insurance: Evidence from the US Affordable Care Act

Labor mobility and the Affordable Care Act: Heterogeneous impacts of the preexisting conditions provision

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