HHS Orders Insurers to Cover All Married Same-Sex Couples

New guidance from the Department of Health and Human Services reminds insurers of their legal obligation to provide family plans to all legally married same-sex couples, regardless of where the family resides.

The guidelines, issued Friday from the Centers for Medicare and Medicaid Services' Center for Consumer Information and Oversight, clearly state that it is illegal for insurance providers to deny family coverage to legally married same-sex couples if the company provides family coverage to married opposite-sex couples. Calling such practices discriminatory, the guidance notes that the clarification "is consistent with the policy of ensuring that all individuals have access to health coverage." The guidance extends to all insurance providers, including those accessed through the Affordable Care Act and plans booked though Healthcare.gov.

As Andrew Cray explains at Think Progress:

"Coverage for same-sex spouses must be offered regardless of the state where the couple lives, or where the policy is issued, so long as the couple is legally married. This determination is based on regulations implementing the law, which prohibit discrimination on the basis of sexual orientation in marketing and plan benefit design. The guidance does not speak to coverage for domestic partners or couples in civil unions."

Although the memo doesn't specifically mention what prompted the guidance, it seems likely that recent reports of same-sex couples being denied family plans in North Carolina (where the decision was eventually reversed), Pennsylvania, and Ohio were a factor in seeking clarification. None of those three states embraces marriage equality, though all have ongoing legal challenges aiming to strike down each state's marriage ban.