Saint Louis University Journal of Health Law & Policy

Document Type

Student Comment


Disabled people have long been systematically excluded from marriage, despite its personal, religious, cultural, and symbolic importance, and despite it being treated as a fundamental right in other contexts. This exclusion has been perpetuated by arcane laws that require Social Security and Medicaid beneficiaries to include their spouse’s income and assets in eligibility calculations. Since eligibility is contingent upon very little income and very few assets, couples who marry and intend to keep benefits are forced to live far below the poverty line in order to meet income and asset criteria, and many people are unable to make such a serious financial sacrifice. As a result, disabled people who are dependent on benefits are often forced to choose between a long-term relationship and needed health care services that are exclusively offered by Medicaid. This disability marriage penalty runs afoul of both disability rights and marriage policies that assure, on one hand, that presence of a disability does not preclude a person from enjoying full rights to inclusion in the United States, and on the other, that marriage is a fundamental right that should not be curtailed for most reasons related to identity. Partial solutions to the disability marriage penalty have been proposed and, in some cases, implemented, but no complete solution yet exists. However, there is some promise that the Biden administration and Congress as it currently stands will begin to take legislative or executive action to abolish this outdated penalty and finally allow people with disabilities the freedom to marry without fear of losing the benefits that enable their continued independence and survival.