The only thing I see is the income tax from when the loan is forgiven in 25 years but that's it. Am I missing something?
So I gave it more thought and here's an argument against it: you're taking a non-dischargeable debt out against a lender that has the ability to garnish wages, social security, file tax liens, and seize tax returns. The terms and interest rates are attractive even if the "worst case scenario" should happen and you are required to pay the loan, but I'm going to invoke the "life happens" clause and am trying to imagine a scenario where assets and income have to flow to the spouse, thus triggering repayment when a repayment is not actually feasible.
Say you are critically injured, are unable to work, and have exhausted any long-term disability insurance. Your non-working spouse now has to work to make up the income drop, and if you have to be confined to a nursing home, in order to have Medicaid cover it, you'll have to spend down/transfer assets outside of the 5 year window (I think, I'm not an expert at Medicaid asset relinquishment). This essentially turns the non-working spouse into the breadwinner and triggers repayment.
There's holes in my scenario there, but when faced with a 20-25 year gamble presuming all factors have to stay the same, it's a touch risky IMO. I probably wouldn't do it.
You're almost better off doing the credit card extraction dance.... open and build up credit card limits, take out cash, set aside a set ratio for settlement, and default. Take the charge off and ensure the cash settlement prevents legal action, which obviates the need for bankruptcy. Set aside for taxes from the 1099C, and that's that. I had a business owner friend net about $60k after taxes/settlement this way.