Academic journal article Journal of Marriage and Family

Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

Academic journal article Journal of Marriage and Family

Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

Article excerpt

Love and commitment are often what couples believe secure and protect marriages from divorce. Sociologists of the family, however, have found that practical considerations are probably more important (Kalmijn, 1998). Married couples with high incomes are more likely to stay married (Amato, 2010; Gibson-Davis, Edin, & McLanahan, 2005). Educational attainment-an indicator of earnings potential-is also associated with greater marital stability (Amato, 2010). Education and income are consistently stronger predictors of divorce than sentiment-driven indicators. Recognizing the significance of these factors, researchers are careful to take household income, the couple's educational attainment, wealth, and other resources into consideration as they study divorce patterns. Researchers have yet to study insurance coverage as a factor that can influence divorce. In this study I examined the relationship between health insurance and divorce by asking three main research questions: (a) Is there an association between being insured by a spouse and divorce? (b) Does this association get stronger when one partner does not have an independent source of health insurance? (c) Do these associations differ by gender?

The United States is among the few and perhaps the only developed country that does not provide universal health care to its residents (Jost, 2003). Although seniors over 64 years of age are assured coverage under Medicare, the majority of nonelderly adult men and women are left responsible for securing their own health insurance. Employment and marriage are the top two sources of health insurance for American adults; 24% of nonelderly adult women and 14% of men are covered as a dependent (Kaiser Family Foundation, 2014). In comparison, 55.3% of the adult population gains health insurance though employment (U.S. Census Bureau, n.d.).

Insurance is consequential. Being uninsured is associated with lower health care utilization, increased morbidity, and higher mortality (Institute of Medicine, 2004). Not having insurance creates barriers to adequate access to health care (Institute of Medicine, 2002). Uninsured individuals are more likely to be diagnosed with late-stage cancer-a disease that is often detected at early states during routine doctor visits (Halpern et al., 2008)-and are less likely to have an ongoing relationship with a health care provider (Holahan & Spillman, 2002). In addition, medical expenses contribute to a large portion of personal bankruptcies in the United States (Himmelstein, Thorne, Warren, & Woolhandler, 2009). Considering these known risks of being uninsured, it is not surprising that Americans treat health insurance as a valuable commodity.

Even brief periods without insurance can be costly. As American adults transition into and out of jobs and marriages, they risk losing health insurance coverage (Lavelle & Smock, 2012; Meyer & Pavalko, 1996). No social infrastructure guarantees continued health insurance through these transitions. The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows people to purchase insurance at the lower group rate under certain conditions, but it is available only for limited periods and its costs can be prohibitive, especially for recently unemployed or divorced individuals. Many cannot help but experience a gap in insurance coverage as they change jobs or go through a divorce (Lavelle & Smock, 2012; Swartz & McBride, 1990). These gaps are significant. They can increase premiums or limit payouts even when individuals gain coverage, particularly for those who have ongoing health care needs (van de Ven, van Vliet, Schut, & van Barneveld, 2000). Gaps can also have significant financial consequences for those who fall ill while uninsured.

Researchers who study employment and wages have established that the health insurance benefits are an important part of an employee's compensation; a job that provides health insurance yields substantially higher total compensation than a job with the same salary but no health benefits (Woodbury, 1983). …

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