In Re the Marriage of Travis Sisson and Alfronia Sisson Upon the Petition of Travis Sisson, 843 N.W.2d 866

Dissolution of marriage between Travis Sisson and Alfronia Sisson occurred in 2008; decree awarded joint custody, child support ($1020/month), and rehabilitative spousal support ($1500 for 18 months then $500 for 74 months).
Alfronia planned to return to work after divorce, but did not pursue cosmetology; instead she worked for Younkers, earning around $40,000 pre-divorce and about $18,000 at modification time.
Alfronia was diagnosed with GK multiple myeloma in Oct 2009, with life expectancy generally five to seven years; doctors projected possible continued work for several years but eventual deterioration.
In 2011, Travis sought modification to obtain sole physical care and reduced child support; Alfronia cross-petitioned to increase alimony and child support; in 2012 the district court modified spousal support to $2100/month for life, and required Travis to pay half of unreimbursed medical expenses.
Court of Appeals affirmed some aspects and awarded Alfronia appellate fees; this court granted review to consider whether the modification was proper in light of Alfronia’s cancer and other factors.
The Iowa Supreme Court vacated the appellate decision and, on modification, increased spousal support to $1600/month for life, struck the shared medical expense provision, and upheld retroactivity to March 15, 2012; it also affirmed denial of the custody modification and awarded Alfronia appellate fees.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether substantial change in circumstances justifies modifying spousal support.	Sisson contends no substantial, permanent change.	Sisson argues the cancer and life expectancy justify modification.	Yes; substantial change established to modify support.
Whether permanent spousal support is appropriate given Alfronia’s health and life expectancy.	Sisson argues against permanent, life-long alimony.	Sisson’s health decline and reduced earning capacity justify lifelong support.	Yes; permanent support warranted.
Whether retirement and savings assets can be used as current support to justify modification.	Sisson argues assets should not offset ongoing alimony.	Alfronia's assets may be used to meet current needs given shortened life expectancy.	Yes; retirement and savings funds considered to meet current needs.
Whether alimony should terminate upon remarrying or be retroactive to modification filing.	Sisson argues remarrying could terminate, retroactivity disputed.	Remarriage may terminate; retroactivity appropriate.	Alimony may be terminated by remarriage; retroactivity upheld to 3/15/2012.
Whether district court's allocation of medical expenses is proper.	Sisson challenged sharing future medical costs.	Alimony should cover ongoing medical costs; district court properly allocated.	Removed; future medical expense sharing struck.

Mears v. Mears, 213 N.W.2d 511 (Iowa 1973) (modification governed by substantial change in circumstances)
In re Marriage of Wessels, 542 N.W.2d 486 (Iowa 1995) (extreme change can convert rehabilitative to permanent alimony)
In re Marriage of Marshall, 394 N.W.2d 392 (Iowa 1986) (cancer as potential basis for modification in some cases)
In re Marriage of Olson, 705 N.W.2d 312 (Iowa 2005) (permanent alimony when self-support unlikely over time)
In re Marriage of Shima, 360 N.W.2d 827 (Iowa 1985) (remarriage generally terminates traditional alimony)