It seems like a cynical question: Are there really people who get married in order to get health insurance? In personal essays and private conversations, people have sometimes admitted that they got married, or they are considering marrying, in large part because marriage would give them access to health insurance that they otherwise would not have.
Thanks to research conducted by the economist Joelle Abramowitz, we no longer need to rely on anecdotes. In 2010, young adults had a way of getting health insurance that they did not have before. The Affordable Care Act (ACA) allowed them to stay on their parents’ insurance until they reached the age of 26.
Professor Abramowitz examined the marital status of 1.4 million men and women between 2008 and 2013 – before and after the ACA was enacted. In the key comparison, she looked at whether adults between the ages of 23 and 25 (for whom the parental provision of the ACA was relevant) were more or less likely to have gotten married in the previous 12 months, compared to a slightly older group (people between the ages of 28 and 30).
She found that by 2013, the younger adults, who were potentially affected by the ACA, were nine percent less likely to have gotten married in the previous year than the slightly older adults.
In another study, Abramowitz found that the ACA seemed to have implications for family planning, too. Between 2006 and 2013, the birth rate for women between the ages of 20 and 25 dropped by 10 percent, compared to a group of slightly older women. Their rates of abortion decreased, too. What increased among these women was their use of long-term hormonal birth control. Abramowitz believes, “women switched from less effective but less expensive contraceptive methods, like condoms, to more effective but more expensive ones.”
The studies suggest (but do not demonstrate definitively) that having the option of getting health insurance by staying on their parents’ plan gave young adults more options for living their lives.
Here’s how the author put it. (Readers of this blog will know what this way of thinking misses even before I explain it.)
Taken together, these findings suggest that access to insurance allows young adults to better plan when to marry and when to have children.
In my view, people who do not need to take health insurance into account when deciding whether to get married are likely to ultimately enter into happier and better marriages. People who have more control over family planning have the ability to better invest in careers and education and to start families when they are ready.
I think this is important work. My problem with the conclusion is that Professor Abramowitz seems to think that everyone, ultimately, will want to marry and have children. Having a way of getting health insurance without marrying, she says, allows young adults “to search longer to find spouses who are better matches and form more stable marriages.”
But having a way of getting health insurance without marrying is also good for people who do not want to marry at all.
Scholars are supposed to be on the cutting edge of thinking. I wish more of them would catch up with the realities of contemporary life, and start to understand that plenty of adults are not interested in marrying or having children.