Medical divorce occurs when couples split up so that one spouse’s medical bills do not deplete the assets of the healthy spouse. It has not been studied in the economics literature, but it has been discussed by attorneys and widely reported in the media. We develop a model of medical divorce that demonstrates that divorce is optimal when a couple’s joint assets exceed the exempted asset level. We use the Affordable Care Act’s Medicaid expansion which removed asset tests to qualify for Medicaid as exogenous variation in the incidence of divorce (as it was only implemented by some states). We find that the ACA expansion decreased the prevalence of divorce by 11.6% among those ages 50–64 with a college degree. These results are robust to numerous placebo checks including older subsamples (who qualify for Medicare regardless of assets) and earlier years (before the expansion was implemented). Our results suggest that Medicaid expansion reduced medical divorce.

当夫妻分手时发生医疗离婚，以使配偶的医疗费用不会耗尽健康配偶的资产。经济学文献中尚未对此进行研究，但已由律师讨论并在媒体上广泛报道。我们建立了医疗离婚模型，该模型表明当夫妻的共同资产超过免税资产水平时，离婚是最佳选择。我们使用《平价医疗法案》（Affordable Care Act）的Medicaid扩展，删除了资产测试以符合作为离婚率的外生变异的Medicaid资格（因为仅在某些州实施）。我们发现，在拥有大学学位的50-64岁年龄段中，ACA扩展使离婚率降低了11.6％。这些结果对于许多安慰剂检查均是可靠的，包括较旧的子样本（无论资产如何均符合Medicare资格）和较早的子样本（实施扩展之前）。我们的结果表明，医疗补助扩张减少了医疗离婚。