November 15, 2019

The United States’ Patient Protection and Affordable Care Act (ACA) has improved health for many groups. A recent study from researchers at Drexel University Dornsife School of Public Health (DSPH) shows that the benefits might be greater for married people, especially women.

The research, conducted by Jim Stimpson, PhD, a professor and associate dean of Academic Affairs in DSPH’s department of Health Management and Policy, and published in the journal PLOS ONE, found that among people receiving Medicaid in states that expanded Medicaid coverage after the ACA, “Medicaid expansion differentially lowered uninsurance rates and improved Medicaid coverage for married persons, especially married women, more than unmarried persons.”

Under the ACA, 25 states across the United States expanded coverage by 2014. In general, health insurance rates have improved more in these states than in states without expansion. This is the first study to show the impact of marital status — a predictor of other health care access factors — on ACA-related Medicaid coverage.

Stimpson and his team analyzed data on almost 4 million adults from the American Community Survey from 2010 to 2016. The researchers found that after expansion, uninsured rates were 1.6 percentage points lower for married women than for unmarried women (a similar difference was not seen for men). Unmarried persons have historically been more likely to be uninsured than their married counterparts, and it appears these differences have widened post-ACA.

Read the full study.