December 18, 2013
A SHADAC study published in the American Journal of Public Health (AJPH) finds adults in same-sex relationships less likely to have employer-sponsored health insurance (ESI) compared to their counterparts in married, opposite-sex relationships. ESI disparities were narrower in states that had legalized same-sex marriage, civil unions and domestic partners that guaranteed equal spousal rights and protections to same-sex couples. Other study results include:
- Men and women in same-sex relationships were less likely to have insurance through an employer nationally, but observed gaps in coverage ranged from modest disparities in the Midwest to marginal advantages in the Western United States.
- Mean ESI coverage rates for men in Vermont, Hawaii, New Mexico, South Carolina and Wisconsin and for women in Michigan and Alabama were 15% lower than ESI coverage rates for married adults in opposite-sex relationships.
- Observed ESI disparities were negligible for men and favorable for women in same-sex relationships in states that recognized legal same-sex marriage.
These findings were based on data from American Community Survey on over 30,000 non-elderly adults in same-sex relationships, making this the largest study on insurance coverage among same-sex couples to date. This study adds to the growing body of public health research documenting the health benefits associated with same-sex marriage. Although most Americans, some 55%, are covered through their own or a family member’s employer-sponsored health insurance plan, many employers do not extend coverage to same-sex partners or children of same-sex partners. Even among large companies with more than 500 employees, only half offer health benefits to same-sex partners.
When states legalize same-sex marriage or civil unions, many workplaces offering health insurance are required to treat married same-sex couples like married heterosexual couples. Five states, including Minnesota, legalized same-sex marriage in 2013, and given that public opinion is rapidly shifting in support of same-sex marriage, several states are expected to advance protections for same-sex couples in the near future.
This study was led by SHADAC doctoral student Gilbert Gonzales and co-authored by SHADAC director Lynn Blewett.