The struggle for same-sex couples to access health-insurance benefits has been long-standing. Despite some employers offering same-sex benefits, Pennsylvania same-sex couples could not access the Affordable Care Act Marketplace as a family unless they were married in another state that allowed same-sex marriage. The federal District Court’s recent decision to overturn the ban on marriage equality now allows same-sex spouses in Pennsylvania immediate access to health care through the Affordable Care Act.
The Affordable Care Act, passed in 2010, established a series of changes to health care that have greatly benefited Americans. Insurers are no longer allowed to charge more for preexisting conditions. Free preventative care is mandated. Individuals under 26 are allowed to continue being on their parents’ insurance. Insurance companies are being held responsible for rate increases. And the Health Insurance Marketplace was established, allowing people to shop for affordable health insurance, qualifying for tax credits and other financial assistance based on their income.
Now that Pennsylvania allows same-sex couples to be legally married, they are able to access the same rights under the Affordable Care Act that they deserve. For too long, benefits have been difficult to obtain or piecemeal for same-sex couples. Even though open enrollment is over, getting married qualifies someone to enroll in the Affordable Care Act Marketplace. This means any newly married same-sex couples have the ability to get quality, affordable health insurance as a family, with possible financial help — even if they have not had insurance before.
When a couple marries, this can result in a Qualifying Life Event. Having a Qualified Life Event could allow you to enroll in health insurance through healthcare.gov as long as you do not have access to other affordable health insurance through your employer or your partner’s employer, and are not receiving or are eligible to receive Medicare, Medicaid or other health benefits. Depending on your income, you may qualify for financial help to pay for premiums and out-of-pocket costs (co-pays and deductibles). Couples have within 60 days from the official date of the marriage to report the change in status and enroll.
Wendy Davis is director of RHD’s Health Insurance Navigator Program.