A hidden cost of divorce: How people, often woman, lose insurance and financial security | Andrew Zashin, Esq.

Divorce has far-reaching effects on a person’s physical health, financial stability and long-term well-being. The disparity in insurance coverage between those who have it and those who do not have can often be traced back to bad divorce planning. The current structure of the United States insurance system, which ties insurance primarily to employment or marital status, leaves many women particularly vulnerable post-divorce.

Research has consistently shown that woman are far more likely than men to lose health insurance coverage after divorce. The seminal study documenting this modern reality, reaffirmed repeatedly, was conducted in 2012 found that nearly 115,000 American women lose private health insurance in the months following a divorce, and roughly 65,000 if them remain uninsured for months or even years afterward. Women who previously relied on their spouse’s employer-sponsored health plan are at especially high-risk, with nearly one in four of them becoming uninsured within six months of the divorce. This loss of coverage is not so temporary, as many divorced women remain uninsured for more than two years after their marriages end.

It is widely recognized that women are more likely to take on indispensable roles, in a traditional family setting, that reduces their access to employer-sponsored insurance. As a result, they frequently depend on their spouse’s insurance plans. When a marriage dissolves, that dependent coverage vanishes and many women are left in a gray zone – earning too much to qualify for Medicaid but not enough to afford individual insurance plans. According to the University of Michigan, this coverage gap is one of the most significant and under-discussed economic risks facing divorced spouses and women today.

The health and financial consequences of losing insurance can be severe. When the strain of divorce is compounded by the loss of coverage, it leads to a cycle of declining health and increasing out-of-pocket costs. Without insurance, many women forgo preventive care, delay necessary treatments, or accrue medical debt. These consequences extend beyond physical health; they also damage a person’s ability to remain financially independent and rebuild their life after divorce.

While the Affordable Care Act helped reduce some barriers, such as eliminating gender-based pricing and treating divorce as a qualifying life event for new enrollment, it did not eliminate the affordability problem. Premiums and deductibles in the individual market remain high, and many women are unaware of, or unable to, take advantage of these provisions. COBRA coverage, which allows ex-spouses to remain on a former partner’s plan for up to 36 months, is another option, but its cost is often prohibitive. Divorce settlements do not always account for these expenses, leaving women to bear the burden alone unless insurance arrangements are explicitly negotiated in the divorce decree.

Divorce settlements should include clear terms about insurance continuation, payment responsibility, and access to COBRA or ACA plans. That means that the cost of ongoing insurance premiums for a spouse, woman or man, should be considered prior to the divorce settlement and, if at all possible, specifically considered and negotiated as part of the divorce settlement. Thereafter, insurance, health insurance and insurance of any sort, must be treated as a critical component of post-decree planning, especially for those who are not employed full-time.

Policymakers should also consider expanding Medicaid eligibility for the recently divorced and offering targeted subsidies in the ACA marketplace to bridge the affordability gap. Ultimately, greater public awareness is needed so that people can prepare for this risk and advocate for their healthcare and insurance needs during divorce negotiations.

The link between divorce and insurance loss illustrates a broader issue in American social policy. Women are systemically and disproportionately exposed to the loss of insurance coverage during the transformative time of divorce. These gaps in coverage are not just bureaucratic failures – they are deeply human ones, affecting the wellness and future of divorced women. Ensuring equitable access to insurance must be seen as a basic protection in the wake of marital dissolution.

Andrew Zashin is a kosher wine collector and oenophile. He also writes a monthly law column for the Cleveland Jewish News.