What is the healthcare angle of the Olbegefell decision? There is at least one, and probably a few health care angles.
The most immediate healthcare angle on national legalization of same sex marriage is that quite a few couples who are currently living in bigot states and who would eventually marry once their marriage was recognized in their home state, they will be getting married sooner rather than later. That means numerous special qualifying events will be triggered as people begin to join their lives and health benefits together. This aspect of what is a Big Biden Deal is not big deal.
More importantly, I think we will see domestic partner benefits quickly phased out on the private employer group insurance market. Domestic partner benefits were a kludge advanced by companies that wanted to both attract the best talent and quietly advertise that they were not looking to discriminate. Some companies only offered domestic partner benefits to an employee and a designated same sex beneficiary in lieu of offering spousal benefits to same sex employees. Other companies offered domestic partner benefits to employees and one partner where there was an established long term relationship that was usually proven by an examination of how intertwined the two lives were in regards to leases, finances, and length of relationship.
I took advantage of the second configuration in my second job out of college as my then girlfriend and now wife was working without benefits at a theatre company, so my employer covered her as my certified domestic partner. Three months later, we adopted a cat and that sealed the deal for us.
Now that there are no legal impediments to marriage for a GLBTQ couple, the need for the domestic partner kludge is much weaker. Companies will look to transition their domestic partner coverage to spousal and family coverage. The basic logic is that any employee can marry the love of their life, so benefits should follow marriage. From a financial perspective, this will do a few things. First, it will drop a few GLBTQ individuals from domestic partner coverage as they aren’t ready/able/willing to be married, but were willing to sign an affidavit of domestic partnership. These individuals will either go on their lower quality employer sponsored insurance, or go on the Exchanges. Secondly a lot of straight people who were receiving domestic partner coverage will be dropped as employers will look to easily reduce their covered headcount.
The other implication for healthcare is a guarantee of a plethora of lawsuits of GLBTQ married individuals who work at bigot run companies that currently offer employee coverage as well as spousal coverage for straight individuals. The married GLBTQ individuals who are covered as a single person under current employer sponsored coverage could apply for coverage for their spouse and be told no. I am not a health law attorney or an attorney of any sort, but my understanding of labor law is that insurance as an employee benefit can not be denied for an otherwise qualified individual employee for arbitrary reasons.
If the current policy is that anyone with a valid marriage and 36 hours a week qualifies to elect spousal coverage, then on Monday Lbgtq individuals will be going to HR looking to add spouses. There will be a few cases reinforcing the fact that there is only a marriage licence not a straight licence and a probationary Ssm license.
Gin & Tonic
Obergefell.
Viva BrisVegas
@Gin & Tonic: gesundheit
Scott
My company added a new twist in the open season just passed. It offered spousal benefit at one price but required an affidavit that the spouse could not receive employer based health insurance at his/her current place of employment. If he/she could receive EBHI, and chose not to take it and wanted to go on the other spouse insurance then the price went up. Is this a new thing? Didn’t effect me but I was wondering.
Luthe
Well, this one is also going to depend on where said employees and bigot companies are located. 36 states have no explicit laws about discriminating against LGBT* individuals, so anyone who gets a marriage license and heads down to HR the next morning for spousal coverage could find themselves out on their asses. Unfortunately, the stampede for spousal coverage is going to be seriously impeded by this.
(Look, it’s a new issue for HRC now that SSM is over!)
Shakezula
A very interesting point about DP coverage. My company has had it for several years and it maintained that benefit, even after all of the states where it has offices legalized equal marriage.
But you’re missing out on a few factors, including the fact that orientation still isn’t a protected class under federal law. If someone is working for a bigot company in a state where discrimination based on orientation is still legal, people who ask for these benefits will probably just be fired. I imagine people in those circumstances would also have to give a lot of thought to whether they wanted to come out at all.
[or what luthe said. i type slloooow.]
randy khan
My guess is that the phase out of domestic partner benefits will take a long time, and may not even happen. While not too many straight people take advantage of them, some do, and find them useful. Since there’s very little stigma to living together outside the bonds of marriage these days, there still will be unmarried, essentially permanent couples who will want them.
La Caterina (Mrs. Johannes)
@Luthe: I haven’t practiced in employment discrimination in several years, but I seem to recall that Title VII (which is a federal law and thus applicable even in deepest Wingnuttia) can be used in this scenario.
Suppose I am a female employee with a female spouse. The employer denies insurance to my wife while a male employee with a female spouse is provided insurance for his wife. In that case I can claim that I am treated differently than the male employee based on my sex. Now I have a Title VII claim based on sex discrimination.
Xantar
@Scott:
That’s not really new. In Obamacare plans sold on the exchange, you won’t get subsidies if you could be on your spouse’s plan but choose not to.
piratedan
@Scott: no Scott it isn’t. Companies are trying to defray their costs by having fewer people to cover, making it more complicated for working families. Why? Because they can. I’m a contractor, my wife has the “solid” job. The thing is, I can get coverage, but my job is tied to the whim of the contractor who has sub-contracted me for a job that has lasted 2+ years now. Can I get coverage, yes if I had to, but no guarantees that my contract could end and I would then have to go back onto the spouse’s insurance. The organization that I am working for, is trying to sell the asset that I work at, but these things take time and they would like to hire me, but it doesn’t make financial sense for them to do so when there’s a potential management change forthcoming with new ownership, so I keep getting extended by three months, every three months.
The idea that you have to get an affadavit is a new one to me, but it seems like insurance companies are trying to “protect” themselves by not covering anyone that they don’t have to.
sempronia
Richard has a cat? Where are our pet pics?
(that was the point of the thread, right?)
Doug R
A lot of jurisdictions have common law provisions, logically this should extend to same sex couples even if they don’t sign a marriage contract.
Pogonip
@Viva BrisVegas: That’s what I kept thinking whenever a newscaster said the name of the case!
sheldon vogt
@Gin & Tonic: Schadenfreude!
Mike J
@Doug R: Generally you need to present yourself as a married couple.over some (usually longish) period of time. If you weren’t able to legally wed until yesterday, it would have been difficult to present yourself as married.
If you mean “what about people who want to be in a committed relationship but don’t want to get married?” common law marriage *is* marriage. You might as well get the piece of paper.
Doug R
@Mike J: I know this is a Canadian province, but I’m sure at least a few states do something like this: cbc.ca/news/canada/british-columbia/common-law-couples-as-good-as-married-in-b-c-1.1413551
MomSense
I think the Domestic Partner benefits plans were work arounds companies used for varying reasons. We are in new territory now so it should be interesting to see how all the details are sorted out.
Pogonip
I am curious about this scenario. Say Al has one of the few decent jobs left in the U. S. Al’s friend Ben very much needs to see a doctor but he’s a “contractor” and they live in an anti-Obama care state. Therefore Al marries Ben so he can get his diabetes or whatever treated. (I live in a relatively purple state and know of at least two marriages the husbands entered into for precisely this reason, to desperate 40-ish spinsters with good jobs and insurance. No one knows if the wives know the truth of the situation or not and I, for obe, won’t tell them as I think it would be cruel if they don’t know.). Anyway, I am wondering if companies will be on the lookout for such arrangements after Obergefell (gesundheit!) and, if so, will they respond by dropping spousal insurance AND, if so, will workers have any legal recourse? If one company gets away with it, of course they will all follow suit.
Mike J
@Doug R: Which backs up what I said. Common law marriage is marriage. However, it will be easier for you to argue for your rights if you just get the license. If you’re going to call yourself married and you’re not 6 days travel away from the county seat, why not save yourself the headache?
Baud
@Pogonip:
Seems unlikely that companies will drop spousal insurance. It’s not like they are selling it at a loss.
Mike J
@Pogonip: What if somebody gets married to a person of the opposite sex just to get insurance? I don’t see how the gender of the participants alters anything.
Carolinus
I came across an old Slate article on Solicitor General Donald Verrilli’s argument to the SCOTUS on Obergefell v. Hodges. The author predicted Verrilli’s focus on equal human dignity would be very attractive to Justice Kennedy and potentially pivotal.
If SCOTUS Decides in Favor of Marriage Equality, Thank Solicitor General Don Verrilli
And from yesterday’s coverage:
nytimes.com/2015/06/27/us/supreme-court-same-sex-marriage.html?_r=0
KG
@Pogonip: wasn’t that how Boston Legal ended? Denny Crane (Shatner) and Alan Shore (James Spader) got married to each other even though they were very much not ghey. I recall a scene where some sort of gay rights group tried to protest their marriage and the response was “we care about each other, and nobody said marriage had to be about sex.” Quite frankly, insurance companies examining whether marriages are “legitimate” or not is going to be a nightmare. This isn’t a green card marriage – and hell, even the feds don’t go after sham green card marriages with much interest.
Pogonip
@Mike J: It doesn’t legally, but right now it’s relatively uncommon. Now you have a whole new pool of possible participants, and I was concerned how greedy companies might react and what defense employees might have if it happened.
KG
@Pogonip: i think the response is “people get married (and divorced) for a variety of reasons, nobody gets to determine if the marriage is legitimate.” hell, one of the cable channels has run reality shows called Married at First Sight (three couples matched up by experts, to be married for six weeks), and Arranged (about three couples who were part of arranged marriages – one Indian American couple, one Roma couple, and a very white very southern couple).
JGabriel
Richards Mayhew:
Why? Domestic partner benefits would still seem to have a market, wouldn’t they. Much like you and your girlfriend before getting married, there is a growing tendency for people to live together before getting married. Domestic partner benefits may have begun as a kluge to support LGBT couples, but in practice it was shown to have a much wider benefit.
I’m not trying to be argumentative, I’m just curious – because there still seems to be a profitable market there, even though domestic partner benefits might not be as necessary as they were before.
NonyNony
@JGabriel:
Because your EMPLOYER doesn’t want to pay for them, not because the health insurance companies don’t want to offer them.
Right now my current employer is doing everything they can to convince employees to not have family members on their insurance policies. Spouses who work at places that have insurance are required to get insurance from their employer (I don’t know how this is enforced – we haven’t had to worry about it since my wife’s insurance is better than mine anyway). We had to prove that our children were ours by providing copies of birth certificates this year (SSNs were no longer sufficient because reasons). We have one of those “health management” programs that are mandatory for both you and your spouse (if covered) or else your out of pocket share increases – this year I believe it was an additional 50% if your spouse didn’t participate.
As soon as they can cut domestic partner benefits and be able to say “well, we’ll cover you if you get married” they absolutely will. Because they don’t want to be paying insurance for ANY of us anymore and if they could get away with dropping it as a benefit they would jump at the chance.
jheartney
I’m wondering if some bigot companies will try the Hobby Lobby gambit – they could claim “sincerely held” religious objections to providing spousal benefits to SSM couples. I count four SCOTUS votes for sure to support the bigots, and it would come down to Kennedy again.
Roger Moore
@sempronia:
Agreed. Pics or it didn’t happen.
srv
More entitlements for everybody:
Beatrice
@jheartney: Yes. I’m actually quite worried about Hobby Lobby and the great big can of worms waiting to be opened. We may be about to enter the minefield RBG warned us of.
Auntie Anne
@NonyNony:
@NonyNony: @NonyNony: Agree. My employer has already started dropping DP benefits where same-sex marriages were legal. By OE, we will no longer offer DP benefits. That DP benefits may be used the opposite-sex couples does not seem to have occurred to them. I know of a couple of situations where they are, so I think the Company has a surprise in store for them.
GeoHawk
@Doug R: The interesting point in that piece was that common law relationships in BC are occurring three times as frequently as marriages. As a consequence, most employer benefits where this applies (including supplemental health care and dental) are provided to both spouses and domestic partners.
Another thing that we have here but I don’t remember so much in the States is “coordination of benefits” – if you are not completely covered for a service, there is an infrastructure in place to use your spousal coverage to try to fill the gap.
Brachiator
@Mike J:
Some states, notably California, do not recognize common law marriages as valid. People may need to take this into consideration when making decisions about marriage, health insurance, etc.
Brachiator
@srv:
Yeah. And so?
trollhattan
My new favorite headline: “Drone flies abortion pills to Poland.”
Oh, to be a headline editor at the Beeb.
Pogonip
@NonyNony: Yup, they’re always looking for ways to screw the employees, even if they’d make more money, or the same amount of money, if they didn’t.
Fair Economist
An interesting effect there is that a number of straight domestic partners will now – get married!
How is this supposed to destroy marriage, again?
bin Lurkin'
Richard I appreciate your posts but you lost me a long time ago on the ins and the outs of insurance, I can follow quantum mechanics, celestial navigation and relativity fairly well but this stuff breaks my brain.
All I really know at this point is that even though I have insurance I cannot afford to use it and that’s the bottom line. If I have a catastrophic incident at some point I suppose it might do me some good for getting in the door of the ER but as far as getting my ever growing hernia or my mouth full of rotting and painful teeth fixed, it’s not going to happen. My subsidy and premium are pure profit for the insurance company.
Mark
You didn’t talk about the effect on people getting subsidized exchange coverage. Two people who were paying a single rate will now pay a family rate that is more than twice the single rate for their age bracket. At the same time, their subsidy will be reduced because the poverty measure (used to compute subsidies) for two people is less than twice the one-person poverty guideline.
A guy
Marriage is one man one woman. Same sex couples are free to unite in my mind. Call it joe mashed potatoes as far as I’m concerned but I ain’t calling it marriage
sleepy
@A guy:
Yeah, we know: you’re an asshole. But thanks for the reminder, I guess.
Nutella
I was never in favor of domestic partner benefits for people who could get married but decided not to.
We’ve got an administrative system to handle people as pairs or as individuals all worked out in its many economic aspects but some people don’t want to fill out the paperwork that defines the pair. So why should we as a society got to a whole lot of trouble to define a new status and a new set of paperwork for the benefit of the people who don’t care to participate in the standard paperwork?
Once marriage and its employment and insurance benefits are available to everyone (and we’ve still got some distance to go on the employment and insurance front) then I’ll be happy to see domestic partner benefits vanish.