Association for Public Policy Analysis & Management

We exploit variation in access to legal same-sex marriage (SSM) across states and time to provide novel evidence of its effects on marriage and health using data from the CDC BRFSS from 2000-2016, a period spanning the entire rollout of legal SSM across the United States. Our main approach is to relate changes in outcomes for individuals in same-sex households (SSH) [i.e., households with exactly two same-sex adults], which we show includes a substantial share of gay and lesbian couples, coincident with adoption of legal SSM in two-way fixed effects models. We find robust evidence that access to legal SSM significantly increased marriage take-up among men and women in SSH. We also find that legal SSM was associated with significant increases in insurance, access to care, and some preventive care outcomes for men in SSH. Our results provide the first direct evidence that legal access to SSM improved health for adult gay men.