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Same-Sex Couples in California Have Unequal Access to Health Insurance

June 29, 2010

Another example of how anything but marriage (civil unions, domestic partnerships, etc.) produces inequalities.

A recent article released in the journal Health Affairs found that gay men and lesbians who are “partnered” (living together) are much, much more likely to be uninsured due to a lack of access to their partner’s health insurance.  In fact, partnered gay men are less than half as likely to receive health coverage through their partner’s employer.  Partnered lesbians are 75% less likely than their straight peers to have insurance through their partner’s plan.

The research was based on couples in California, a state with more protections for unmarried same-sex couples than most.  A 2005 California law mandates that all group health insurance policies and health care service plans that offer spousal benefits also extend these benefits to state-registered domestic partners.  A 2002 law requires “equal treatment of ‘dependent’ health benefits under state tax law for both public- and private-sector employees.”  However, even with these types of protection, 31% of employers don’t have to cover the partners of gay employees because of the type of insurance plans they maintain.

What impact does health reform have on this situation?  Not a lot.  Until the U.S. Department of Health and Human Services and employers expand the definition of “dependents,” same-sex partners can be treated differently.  Yes, reform is good because once it’s fully implemented uninsured partners will have access to insurance plans and health insurance exchanges without worrying about “pre-existing conditions.” But, as the article points out, subsidies for the exchange only cover people to a certain income level.  Ultimately, middle class, same-sex couples will have to pay more than their straight peers because a civil union or a registered domestic partnership is not the same as a marriage.

Interestingly, the study found no evidence to suggest that employers in California were actively discriminating against gay employees, but they do point to coverage rules that inherently favor legally married, straight couples.  This is further exaggerated by the higher federal tax burden that employees face when enrolling their partners under their health plans.  As I mentioned yesterday, new research from the Williams Institute that found that this cost gay couples an average of over $1,000 per year in taxes alone, and this is certainly not the only place these inequities exist.

The article’s conclusion pretty much sums it up:

Achieving the goal of universal coverage depends, in part, on remedying inequities in state and federal marriage-related rules. In our efforts to rebuild economic strength and security in the United States, it is important to consider the role of public policies in unfairly disadvantaging some minority classes of individuals and their families, and to recognize society’s interest in righting the balance of who bears those costs.

The research was conducted by UCLA and the Lambda Legal Defense and Education Fund.


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