Moderate Effects of Same-Sex Legislation on Dependent Employer-Based Insurance Coverage Among Sexual Minorities

Med Care Res Rev. 2016 Dec;73(6):752-768. doi: 10.1177/1077558715625560. Epub 2016 Jan 12.

Abstract

A difference-in-difference approach was used to compare the effects of same-sex domestic partnership, civil union, and marriage policies on same- and different-sex partners who could have benefitted from their partners' employer-based insurance (EBI) coverage. Same-sex partners had 78% lower odds (Marginal Effect = -21%) of having EBI compared with different-sex partners, adjusting for socioeconomic and health-related factors. Same-sex partners living in states that recognized same-sex marriage or domestic partnership had 89% greater odds of having EBI compared with those in states that did not recognize same-sex unions (ME = 5%). The impact of same-sex legislation on increasing take-up of dependent EBI coverage among lesbians, gay men, and bisexual individuals was modest, and domestic partnership legislation was equally as effective as same-sex marriage in increasing same-sex partner EBI coverage. Extending dependent EBI coverage to same-sex partners can mitigate gaps in coverage for a segment of the lesbians, gay men, and bisexual population but will not eliminate them.

Keywords: LGBT; disparities; employer-based insurance; health coverage; same-sex policies; sexual minorities.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • Health Status Disparities
  • Humans
  • Insurance Coverage / legislation & jurisprudence
  • Insurance Coverage / statistics & numerical data*
  • Insurance, Health / legislation & jurisprudence
  • Insurance, Health / statistics & numerical data*
  • Male
  • Marriage
  • Sexual and Gender Minorities / legislation & jurisprudence
  • Sexual and Gender Minorities / statistics & numerical data*