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June 26, 2013 01:00 AM

New healthcare rights, thanks to DOMA ruling

Joe Carlson
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    Demonstrators celebrate the Supreme Court's decision to strike down the 1996 Defense of Marriage Act.

    (Story updated at 3:30 p.m. ET)

    The U.S. Supreme Court's landmark ruling this morning striking down the 1996 Defense of Marriage Act is expected to have a major impact on health coverage and other benefits for legally married same-sex partners of federal employees and members of the military, as well as on tax treatment for private health coverage.

    The law had barred the government from treating same-sex partners as married, raising the cost of healthcare for same-sex couples and denying them eligibility for federally guaranteed rights such as medical and family leave, and, in some cases, Medicare eligibility.

    The legal question in United States v. Windsor centered on whether the wife of a woman in New York, where same-sex marriage is legal, could take advantage of federal tax exemptions for married couples that were barred by the Defense of Marriage Act.

    “The principal purpose and the necessary effect of this law are to demean those persons who are in a lawful same-sex marriage,” Justice Anthony Kennedy wrote in the 5-4 decision. “This requires the Court to hold, as it now does, that DOMA is unconstitutional as a deprivation of the liberty of the person protected by the Fifth Amendment of the Constitution.”

    DOMA explicitly defined marriage as a union between a man and a woman for the purpose of all federal laws, even though a growing number of states recognize same-sex marriages. Kennedy's 26-page opinion (PDF) says Congress' explicit purpose in passing DOMA was to expose same-sex couples in state-sanctioned marriages to “a disadvantage, a separate status, and so a stigma,” which violated the Fifth Amendment guarantee of rights to life, liberty and property.

    The opinion recites a laundry list of rights denied and harms inflicted on same-sex couples by the law, noting in particular the emotional difficulties imposed on thousands of children in same-sex households who have a harder time understanding the integrity of their own families.

    The law also harmed these children financially, Kennedy wrote, because health benefits provided to same-sex spouses were not entitled to the same federal tax-exemptions as those of heterosexual families', creating unequal costs for same-sex households. The law also denied survivorship benefits for spouses and children through Social Security.

    The decision does not force states to recognize same-sex marriages performed in other states. Rather, it says that only the federal government cannot deny equal protection and rights to couples with marriages that are recognized in their states, including the dozen or so where same-sex marriage is legal.

    “The class to which DOMA directs its restrictions and restraints are those persons who are joined in same-sex marriages made lawful by the State… This opinion and its holding are confined to those lawful marriages,” the opinion says.

    For now, one practical effect of that, legal experts say, is that the legally married same-sex spouses of federal employees in New York, which recognizes same-sex marriage, will receive full marriage benefits, while the non-legally married same-sex partners of federal employees in Pennsylvania, which doesn't recognize such marriages, will not. The same applies to Medicare and military health benefits.

    A fact sheet from Lambda Legal, a civil-rights organization for gay, lesbian, bisexual and transgender people, says that various federal agencies will continue to make their differing decisions on whether to grant full spousal benefits to same-sex couples who were legally married in one state but who reside in a different one that bars same-sex marriage. But the fact sheet says that because the military determines a marriage to be valid based on the law of the state where the marriage took place, it should not matter what state a military member and a same-sex spouse live in to come under the new protection granted by the Supreme Court ruling.

    Jonathan Calpas, an associate attorney in healthcare and employment law with Ballard Spahr in Philadelphia, said a particularly thorny question arises in cases where same-sex couples in Pennsylvania have valid New York marriage licenses—not an uncommon occurrence, since the states border one another.

    Questions of eligibility involving cross-border situations may also arise for private-sector employers in states that have constitutional amendments or “mini-DOMA” laws banning same-sex marriage.

    “I think there is a general outstanding question as to how state constitutions and these mini-DOMA laws affect what employers and the federal government are required to do,” Calpas said. “I don't think anyone knows for sure. I think this is just the opening battle.”

    Mark Colwell, consumer marketing manager for online insurance-portal firm GoHealth Insurance in Chicago, said he sees the ruling as bringing more clarity and uniformity to questions about insurance and eligibility.

    “Amongst states and (insurance) carriers, there had been rules as to how they treated same-sex partners. And now the federal court made the law very clear. It's just a question of how fast can everyone react to this,” he said. “Everyone is a spouse in states where they recognize same-sex marriage.”

    Kennedy joined a liberal majority of the court that consisted of justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, Elena Kagan. Dissenting from the majority in several different opinions were Chief Justice John Roberts and justices Antonin Scalia, Clarence Thomas, and Samuel Alito.

    Scalia, who wrote the main dissent, said the court actually had no jurisdiction to decide the case at all, and the majority's decision to take it on “is an assertion of judicial supremacy over the people's Representatives in Congress and the Executive.”

    “This case is about power in several respects. It is about the power of our people to govern themselves, and the power of this Court to pronounce the law. Today's opinion aggrandizes the latter, with the predictable consequence of diminishing the former. We have no power to decide this case. And even if we did, we have no power under the Constitution to invalidate this democratically adopted legislation.”

    Follow Joe Carlson on Twitter: @MHJCarlson

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