The High Cost of Marriage Inequality

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Marriage equality and benefits for same-sex couples is likely to remain a hot-button political issue for years, as more and more states allow homosexual couples to get married, others allow for civil unions or partnerships, and decisions remain to be seen at a national level. According to the Williams Institute at the University of California Los Angeles School of Law, there are 650,000 same-sex couples in the U.S., about 20% of whom are raising children under 18 years old.

As it stands now — while states across the country pass laws granting equal rights, but the nation as a whole has yet to grant equal standing — a lot of things are up in the air in terms of benefits and health insurance for same-sex couples and often, their children.

What Does This Mean?

According to the National Conference of State Legislatures, as of May 2013, 11 states allow same-sex marriages, with all the same benefits and rights of heterosexual marriages. Four additional states offer civil unions, and four others allow domestic partnerships with varying degrees of benefits and rights.

In Illinois, for example, which offers civil unions, same-sex couples have the right to visit a sick partner in the hospital and make decisions about their partner’s medical care and disposal of remains, as necessary. In Oregon, which allows domestic partnerships, same-sex couples are offered all of the benefits of marriage under state law, but no federal benefits or protections, such as Social Security survivor benefits. In Nevada, which also offers domestic partnerships, couples all have the same rights, but employers are not required to provide health care coverage for domestic partners.

For same-sex couples whose states do not recognize their union or do not give it the same rights and benefits of heterosexual marriages, private health insurance is the only option until full benefits of the Affordable Care Act kick in. According to the Center for American Progress, the Affordable Care Act will mean big changes for same-sex couples, particularly those in the lowest income brackets. Under the law, those who buy coverage — as individuals or as a couple — through the insurance marketplace can receive subsidies based on their income level. Additionally, nothing in the law can keep couples from combining their subsidies and purchasing family coverage.

In states that do legally recognize same-sex unions in some form, states often require insurers to extend family coverage to same-sex couples. According to the center, many insurers even in states that don’t recognize same-sex unions extend coverage to same-sex partners of employees. The act is expected to expand such practices, and allows insurance marketplaces to offer coverage to same-sex couples and their children beginning in 2014.

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