While the House and Senate may be out on Easter Recess, this time of year is anything but slow for the Supreme Court. Just one year ago this week, the nine justices heard the oral arguments in NFIB v. Sebelius. This year, the court is taking up the Defense of Marriage Act (DOMA), which could have significant health insurance implications should the law be overturned.
The DOMA was signed into law by President Bill Clinton back in 1996. The law defined marriage as a union between a man and woman for federal legal purposes. Even though a number of states have moved to recognize same-sex marriages and civil unions, gay couples do not get to enjoy any federal tax or insurance-related benefits heterosexual married couples do, including access to COBRA and the federal income tax exclusion for the value of employer-sponsored health insurance coverage. Recent research has indicated that private insurers and employers are increasingly providing family health insurance to same-sex couples, but their bills and taxes are still higher. Under DOMA, same-sex couples are not granted the same tax breaks that heterosexual married couples are, which means that any spousal employer-sponsored health insurance coverage is seen as taxable income. M.V. Lee Badgett, director of the Center for Public Policy and Administration at the University of Massachusetts-Amherst, noted “that extra taxation probably discourages some couples from signing up a partner for financial reasons, leaving them uninsured and vulnerable.”
If the court does not strike down DOMA less access to health insurance and steeper costs will continue to be the reality for same-sex couples since PPACA does little to help the issue. This is despite the fact that Secretary Kathleen Sebelius in a statement reminded the public that PPACA will ensure that more Americans have access to health insurance and that it specifically gives same-sex Medicare and Medicaid patient’s visitation rights.
If the court does strike down the law we are likely to see a great increase in the number of people seeking spousal health insurance coverage, pulling more people into the health insurance marketplace. A decision by the Supreme Court in the United States v. Windsor is expected to be announced in June.