Access to Employer-Sponsored Health Coverage for Same-Sex Spouses: 2020 Update

Data Note
  1. Virtually all employers offering health benefits offer spousal coverage, allowing over half those covered by an employer plan to be covered as a dependent.

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  2. Kaiser Family Foundation. Health Insurance Coverage of the Total Population, 2019. State Health Facts. https://www.kff.org/other/state-indicator/total-population/

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  3. Note: the survey was largely fielded prior to the Bostock decision, see Methods.

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  4. Additional detail about these Supreme Court cases is available in the Appendix.

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  5. This increase was driven by the smallest firms so this finding may have some year-to-year volatility based on the mix of small firms sampled.

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  6. Distribution of Employers, Workers, and Workers Covered by Health Benefits, by firm size, 2020 from The KFF 2020 Employer Health Benefits Survey (2020). Exhibit available here: https://www.kff.org/report-section/ehbs-2020-survey-design-and-methods/#figurem6

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  7. Distribution of Employers, Workers, and Workers Covered by Health Benefits, by firm size, 2020 from KFF 2020 Employer Health Benefits Survey (2020). Exhibit available here: https://www.kff.org/report-section/ehbs-2020-survey-design-and-methods/#figurem6

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Appendix
  1. The first employer to do so was the Village Voice in 1982. (Appleby, J. May 14, 2012. “Many Businesses Offer Health Benefits To Same-Sex Couples Ahead Of Laws.” PBS Newshour. Retrieved from: http://www.pbs.org/newshour/rundown/many-businesses-offer-health-benefits-to-same-sex-couples-ahead-of-laws/.)

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  2. Massachusetts became the first state to recognize same-sex marriage in 2003. By June 2013, 12 states and the District of Columbia recognized gay marriage. (See Honan, E. June 26, 2013. “Factbox: List of states that legalized gay marriage.” Reuters. Retrieved from:

    http://www.reuters.com/article/us-usa-court-gaymarriage-states-idUSBRE95P07A20130626.)

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  3. Among Large Firms Offering Health Benefits, Percentage That Offer to Unmarried Opposite-Sex and Same-Sex Domestic Partners, 2008-2019, from The KFF 2019 Employer Health Benefits Survey (2019). Exhibit available here: https://www.kff.org/report-section/ehbs-2019-section-2-health-benefits-offer-rates/#figure213

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  4. IRS Revenue Ruling 2013-17,  August 29, 2013. https://www.irs.gov/pub/irs-drop/rr-13-17.pdf.

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  5. However, the Windsor decision ensures federal employees and contractor employees, have access to same-sex spousal coverage at parity with opposite-sex spousal coverage offerings and the Obergefell ruling means that spousal coverage benefits should be extended to state and municipal employees across the nation to the same degree as their heterosexual counterparts.

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  6. Gonzales G. “Association of the New York State Marriage Equality Act with Changes in Health Insurance Coverage.” JAMA. 314(7). 2015.

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  7. Human Rights Campaign. Map of State Laws and Policies- Statewide Employment Laws and Policies. Available at: http://www.hrc.org/state_maps. Accessed 10/15/20.

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