Much of today’s debate over expanding Medicaid, nearly seven years after Obamacare was ushered into law, consists of well-worn talking points. But two economists in Kansas have added a fresh twist, as Republicans attempt to roll back the law.
The researchers found that in states that expanded Medicaid, divorce rates fell among Baby Boomers.
What does Medicaid have to do with the success of a marriage?
Let’s use a middle-class couple in their 50s as an example. They’ve saved up a decent amount of money over their lifetimes, then one of them is diagnosed with Alzheimer’s. They face the prospect of draining their hard-earned retirement accounts to pay for medical and long-term-care bills.
Instead, they opt for a “medical divorce.” By splitting up, the sick spouse could then qualify for Medicaid, which — before Obamacare — was open only to people with assets below a certain amount (generally $3,000 for a couple). The healthy spouse hangs onto the savings, while the sick one relies on Medicaid to pay those bills.
(For a real-world example, check out “Until Medical Bills Do Us Part,” by New York Times columnist Nicholas Kristof, which inspired the economists’ work.)
Under Obamacare, however, anyone can qualify for Medicaid under the expansion, as long as their income is below 138 percent of the poverty level (about $22,000 a year for a couple). Assets don’t figure into eligibility.
The authors of the new paper, David Slusky and Donna Ginther of the University of Kansas, compared divorce rates, pre- to post-Obamacare, in states that expanded Medicaid to states that did not, including Maine. They looked specifically at those aged 50 to 64, because they likely had been married for many years, had accrued significant assets, were at a higher risk of a degenerative illness, and were eligible for the Medicaid expansion, according to a press release about their findings.
(At age 65, older adults become eligible for Medicare).
The economists found that in Medicaid expansion states, there was a 5.6 percent decrease in the prevalence of divorce among people aged 50-64, compared with states that didn’t expand.
“This suggests that Medicaid without asset limits for low-income individuals significantly reduced the incidence of divorce, strongly suggesting that medical divorce was reduced in the first year of the Affordable Care Act,” they wrote in the working paper, distributed by the National Bureau of Economic Research.
Certainly other factors could be contributing to the decline in divorce rates in those states. And others have pointed out that Medicaid still imposes some asset tests for certain groups, including those likely to resort to medical divorces because Medicaid is the only option for them to afford long-term care services.
But it’s an interesting new angle to ponder as Mainers prepare to vote in November on whether to expand Medicaid, a referendum given new urgency with Tuesday’s roll out of House Republicans’ health plan.