Til Insurance Do Us Part: the Effect of the Affordable Care Act Preexisting Conditions Provision on Marriage

J. Matthew Hampton, Otto Lenhart

Research output: Working paper

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This paper investigates the effect of the 2014 Affordable Care Act preexisting conditions provisionon marriage. The policy was implemented to prevent insurers from denying insurance coverage to individuals with health conditions. We test whether the implementation of the provision led to decreases in marriage among affected adults. We add to earlier work on how marital behavior is influenced by policy incentives and examine for the presence of “marriage lock”, a situation in which individuals remain married primarily for insurance. Using data from 2009-2015 and difference-in-differences models, we find that males with preexisting conditions are 5.15 percentage points (6.40 percent) less likely to be married after the policy implementation. Effects are largest for men who had insurance coverage prior to the policy change from a source other than his own employer, suggesting that the inability to attain individual coverage and reliance on spousal insurance provided incentives to remain married.
Original languageEnglish
Place of PublicationGlasgow
PublisherUniversity of Strathclyde
Number of pages35
Publication statusPublished - 6 Feb 2019

Publication series

NameStrathclyde Discussion Papers in Economics
PublisherUniversity of Strathclyde


  • affordable care
  • marriage
  • 2014 Affordable Care Act
  • insurance industry
  • health insurance
  • ACA
  • health insurance industry

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