Thursday, January 28, 2016

Health Implications of the Supreme Court's Obergefell vs. Hodges Marriage Equality Decision

The United States Supreme Court's Obergefell vs. Hodges groundbreaking marriage equality decision also created new terrain for lesbian, gay, bisexual, and transgender (LGBT) persons regarding health, healthcare, and health benefits. This article addresses the health implications of this decision by examining its impact on minority stress and stigmatization and health-related benefits. It also includes a discussion of several impending issues affecting LGBT health that remain after Obergefell.

…In the wake of Obergefell, several issues remain that affect LGBT health. First, LGBT employees with self-funded insurance plans may find themselves battling employers and insurance companies to cover their same-sex spouse. Second, employers may decide not to cover any spouses to avoid coverage for same-sex spouses. Employers will also wrestle with whether to continue coverage for unmarried persons, now that marriage equality has been attained. Third, the Obergefell decision does not directly address health coverage or equal rights in healthcare for transgender persons, and the battle for equal health coverage will remain. Fourth, insurance plans that exclude same-sex couples for fertility treatments and surrogate parenting may confront more litigation for discrimination. Fifth, because marriage bestows only certain protections—and protects only spouses—increasing efforts will focus on eliminating discrimination in areas like employment and housing. Given research on the health implications of such discrimination, the passage of such laws may result in better health among LGBT persons. Finally, employers and legislators may carve out religious exemptions for healthcare coverage and other areas that affect LGBT health. The Supreme Court's 2014 decision in Burwell vs. Hobby Lobby already ruled that corporations might be exempt from the Affordable Care Act's requirement that employers cover contraception, if the company's owners have religious objections. Immediately after the Obergefell decision, several states allowed county clerks to refuse issuing marriage licenses to same-sex couples for religious reasons. Demands for religious exemptions will likely grow over the next few years.

Full article at:

By:   Angela K. Perone, JD, MSWcorresponding author
Department of Sociology, University of Michigan School of Social Work, Ann Arbor, Michigan.
corresponding authorCorresponding author.
Address correspondence to:, Angela K. Perone, JD, MSWDepartment of SociologyUniversity of Michigan School of Social Work1080 S. University AvenueAnn Arbor, MI 48109E-mail: Email: ude.hcimu@aenorep

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