DOMA Decision Impacts Health Insurance, State Budget

Today’s Supreme Court decision holding part of the Defense of Marriage Act unconstitutional will have a number of impacts on health insurance eligibility and costs for same-sex married couples. It also might impact the state budget.

Attorney General Martha Coakley quickly put together today a FAQ page, at mass.gov/doma looking at many of these issues. It includes analysis and answers to questions like:

  • I am part of a married same-sex couple in Massachusetts.  Can I add my spouse to my health insurance plan?
  • Will my MassHealth coverage be affected by the Supreme Court’s decision?
  • I am a Massachusetts state employee and I have already added my same-sex spouse to my health insurance.  When will my paycheck reflect that the federal government is no longer taxing my spouse’s health insurance coverage?

The last question is an important impact of today’s decision. Until now, married same-sex couples had to pay federal income tax on the amount spent by employer’s to provide health benefits to their spouse. This added cost, called the “imputed income” tax, will end.

There’s also a hotline phone number and links to other resources, including a great series of detailed fact sheets by our downstairs neighbors and friends at GLAD, Gay & Lesbian Advocates & Defenders.

On the policy front, lots of analysts are looking at the impact on insurers and subsidized health coverage. Washington Post health care blogger Sarah Kliff concluded that it will be complicated. Married couples who were considered two single individuals for federal benefit purposes because of DOMA will now be considered a family of two. Depending on their incomes, the decision might make them both now eligible, or both ineligible for coverage assistance.

In Massachusetts, the state was already treating same-sex married MassHealth and Commonwealth Care applicants as married, and forgoing federal reimbursements if they qualified for coverage solely due to our marriage laws. Thus the DOMA decision may slightly help our budget, as we will now get federal revenue for part of their subsidy costs.

HCFA hopes the Supreme Court decision will provide more Massachusetts residents access to quality, affordable, comprehensive health insurance coverage.
 -Brian Rosman

About HCFA

The Ultimate Massachusetts Health Care Insider Information
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