Gay Marriage

Practical Concerns Often Drive Desire for Same-Sex Marriage

Couples want access to insurance, equal tax consideration


The Supreme Court's Obamacare decision might have been its highest-profile foray into health policy in a generation, but the court's action on gay marriage could have a pretty big impact of its own.

The federal Defense of Marriage Act, under review by the high court this week, allows states to ignore gay marriages or unions sanctioned outside their borders, and it excludes legally married gay couples from the same protections offered to heterosexual couples under federal health programs, like Medicare, Medicaid and the Consolidated Omnibus Budget Reconciliation Act.
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The result is thousands of same-sex couples facing more limited access to health insurance and steeper costs for coverage than their heterosexual counterparts.