The Alternatives to Marriage Project believes that access to employer based health insurance in the United States should not be determined by relationship or marital status. Although we applaud efforts by some businesses to make health insurance more accessible (by offering domestic partnership benefits, for example), we believe further steps must be taken to ensure that marital status is not a barrier to health care.

In this section:

• The Problem 
• Our Solutions

Problem: the current system discriminates

The health care system in the United States distributes insurance unevenly and unfairly. Unmarried people are disproportionately uninsured. Marital status discrimination is built into the current system because it relies on employer-based health insurance. In addition to the obvious financial barriers, access to health insurance is limited by federal laws regulating employer based insurance, the federal government's definition of family and a number of state laws regarding employer based insurance.

The Employee Retirement Income Security Act (ERISA) prevent states from directly requiring employers to provide health insurance to employees and their families. This allows employers to choose whom they want to cover, which in turn gives employers the power to define what constitutes family. Consequently, employers often use martial status as the sole determinant of whether someone will receive employer-based insurance through a partner.

The Defense of Marriage Act (DoMA) strips unmarried families of the rights and privileges afforded to their married counterparts. DoMA defines marriage as solely between one woman and one man and "spouse" as an opposite sex husband or wife. Job-based benefits for spouses and dependents are not taxed as income but, because DoMA defines "spouse" so narrowly, unmarried partners are required to pay taxes on whatever employer benefits they receive. The Consolidated Omnibus Budget Reconciliation Act (COBRA) provides employees and "qualified beneficiaires" continued insurance coverage after loss of employment, divorce or the death of an employee. Since "spouse" only applies to an opposite sex husband or wife, all unmarried partners, regardless of whether or not they were previously covered, are not entitled to continued coverage under COBRA.

In some states, adult children have continued access to their parents' health insurance for several years after their 18th birthday. Unfortunately, in most of these states, continued coverage is guaranteed only if the adult child remains unmarried. Young adults (between the ages of 19 and 29) have the lowest insurance rate of all age groups.

 

Solutions

AtMP has analyzed a wide variety of current health care reform proposals. To download the entire analysis, including over a dozen specific recommendations, click here. Here are a few of solutions we're advocating:

1. Convince more employers to voluntarily cover both same and different sex domestic partners.	For our advice on how to do that, click here.
2. Amend and pass the federal Domestic Partnership Benefits and Obligations Act, to provide health insurance to all domestic partners of federal employees.	Click here to send a letter to Congress
3. Get your city or state to pass an Equal Benefits Ordinance requiring any contractor doing business with local government to offer domestic partners the same benefits as married couples.	The Human Rights Campaign has compiled a list of places that have Equal Benefits Ordinances.
4. Get your state to extend parents’ health insurance to cover adult children, without ending if the child gets married.	The National Conference of State legislatures has a chart and brief discussion of state laws that extend dependent coverage to adult children.
5. Repeal the Defense of Marriage Act: DoMA makes domestic partner benefits more expensive than spousal benefits, and blocks unmarried partners from COBRA coverage.	Well, maybe in the next administration...

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