Supreme Court’s Same-Sex Ruling Could Affect Access to Coverage
The Supreme Court's ruling that same-sex couples have the right to marry throughout the U.S. likely will affect access to health coverage, National Journal reports (Scott, National Journal, 6/26).
The high court on Friday ruled 5-4 that the Constitution guarantees a right to same-sex marriage (Liptak, New York Times, 6/26).
Experts: Coverage Gains Probable
Experts have said that the decision likely will increase health insurance coverage among same-sex couples by allowing previously unmarried individuals to now access employer coverage through a spouse, Kaiser Health News reports. Among employers that offer health benefits, nearly all make such coverage available to spouses. However, fewer than half of such companies offer health benefits to unwed same-sex partners.
For example, a new study in the Journal of the American Medical Association found that there was a notable increase in same-sex couples with employer-sponsored coverage in New York after the state legalized same-sex marriage in 2011.
However, lawyers have offered different responses about whether employers are now obligated to offer health insurance to same-sex spouses that they make available to opposite-sex spouses, KHN reports. Edward Fensholt, a benefits lawyer at Lockton Companies, said the decision does not mandate companies to offer benefits to same-sex spouses that they offer to opposite-sex spouses, but most would.
Lambda Legal, who advocates for rights for same-sex couples, said such a refusal would violate federal sex discrimination law. Jennifer Kates, a Kaiser Family Foundation vice president, said that the ruling "coupled with existing federal protections, would set up a strong case that employers could not discriminate."
Further, state laws could also require equal benefits for same-sex spouses (Hancock, Kaiser Health News, 6/29).
ACA Coverage Implications
However, same-sex couples could now experience the "annoyances" of certain Affordable Care Act provisions that apply to married couples, National Journal reports.
For example, under the ACA, individuals who would be eligible for the law's subsidies can become ineligible if their partner's income elevates their household income above a certain level. According to National Journal, the number of residents affected by the ACA's "marriage penalty" is relatively low.
The ruling also means that same-sex couples could face the ACA's "family glitch" as well (National Journal, 6/26). The family glitch refers to when individuals' incomes are too low to afford coverage for their families through their employer but too high to qualify for subsidies through the exchanges (California Healthline, 5/12).
Effect of Domestic Partner Coverage
In related news, the ruling could lead employers to scale back or eliminate domestic partnership benefits and require that workers be married to keep benefits for their partner, Modern Healthcare reports (Schencker/Herman, Modern Healthcare, 6/26).
Currently, about two-thirds of Fortune 500 companies allow an employee's same-sex partner to access employer health care coverage. Some companies provide these plans as an alternative to same-sex couples who might be barred from getting married. However, about 62% of companies that provide domestic partner coverage options to same-sex couples also afford such benefits to opposite-sex couples, according to the Human Rights Campaign (Siegel Bernard, New York Times, 6/28).
As more states have legalized same-sex marriage, some employers have scaled back domestic partner plans (Modern Healthcare, 6/26). For example, Verizon last year said that couples in states where same-sex marriage was legal had to wed in order for partners to be eligible for company benefits (Kaiser Health News, 6/29). Excellus Blue Cross and Blue Shield in New York gave employees 15 months to marry for partners to be eligible employer coverage (Modern Healthcare, 6/26).
Some LGBT advocates have noted that requiring same-sex couples to get married to access employer health benefits could have the result of revealing a person's sexual identify, as marriage licenses are public.
Human Rights Campaign Legal Director Sarah Warbelow in a statement said, "If an LGBT employee is, in effect, 'outed' by being required to obtain a public marriage license in a state that doesn't provide explicit nondiscrimination protections, it could place that employee and their family at risk of being denied credit, housing and public accommodation."
In addition, some have raised concern about the effect reductions in domestic-partner coverage options could have on opposite-sex couples as well. Meanwhile, benefits professionals do not anticipate that a large number of companies will eliminate domestic partner benefits, especially if they already make them available to opposite-sex couples (New York Times, 6/29).
Sen. Urges VA Action
In other related news, Sen. Jeanne Shaheen (D-N.H.) in a letter to Department of Veterans Affairs Secretary Robert McDonald is urging him to "act as quickly as possible to implement the spirit of the [Supreme] Court's decision, and ensure that all veterans' benefits are awarded to eligible same-sex families," The Hill's "Floor Action" reports.
Under current protocols, VA holds that state laws can block the department from allowing a same-sex partner to access a partner's benefits.
Shaheen wrote that system means "veterans with identical service records, disability ratings, and family size have received different benefits based on where they live and whom they love."
Senators have voted to give VA benefits to same-sex couples as part of a budget vote earlier this year, though such votes are nonbinding (Carney, "Floor Action," The Hill, 6/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.