For Better or For Coverage: Marriage, Divorce, and Women’s Health Insurance After the Affordable Care Act

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 22. Health Insurance

Abstract

Research conducted prior to the implementation of the Affordable Care Act (ACA), demonstrated that unmarried and married women had different health insurance coverage patterns and that divorce placed women at an elevated risk of losing health insurance coverage. However, the ACA led to a major transformation of the U.S. health insurance system, and it is possible that the ACA weakened the relationship between marital status and health insurance coverage. I revisit this question through an examination of the 2018, 2020, 2021, and 2022 panels of the Survey of Income and Program Participation. Specifically, I ask 1) whether married and unmarried women have different types of health insurance coverage and whether this differs between states that adopted the ACA Medicaid expansion and those that did not adopt the expansion, and 2) whether marriage or divorce is associated with changes in health insurance coverage and if these changes differ in expansion and non-expansion states. I find that marital status remains relevant for women’s health insurance coverage, but the ways in which marital status matters differ by whether women are living in expansion or non-expansion states. Consequently, the ACA may contribute to shielding women from negative economic consequences of divorce.

Author

• Elizabeth M. Anderson, University of Kansas