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How do the marketplaces work for same-sex married couples?

Same as for any married couple

Published: October 04, 2013 07:12 PM

Q. My same-sex partner and I are legally married but we now live in a state that does not recognize same-sex marriage. He needs health insurance. I make a modest income and get coverage through my employer but he makes very little. How will the marketplace work for us?

A. The same as it does for any married couple. In fact the government issued guidance on this very question just last week, making it crystal-clear that same-sex married couples are eligible for premium tax credits in their state Health Insurance Marketplace even if they live in a state that doesn't recognize their union's validity.

Now, in your particular situation there are a couple of other things to consider.

First, you need to find out whether your employer offers spousal coverage to your husband. If it does, it constitutes an "offer of employer coverage" to him and most likely precludes him from getting a tax credit to offset the costs of his premium in a marketplace plan regardless of income. (There are some exceptions to this, which I explained in this earlier blog.)

Health reform countdown: Today is day 13 of our 100-day Health Reform Countdown. We're getting ready for Jan. 1, 2014, when the new health law takes full effect. See the previous posts in the series. And for more information, use our Health Law Helper. Answer a few simple questions about where you live, your income, and how you get insurance now, and it gives  advice tailored to your situation.

If he can't get coverage through your job, then his eligibility for a premium subsidy will depend on your joint household income, not his alone. In fact, if he wants to claim a subsidy at all, you'll have to file your 2014 tax returns jointly.

If your "modest" income plus his "very little" come to less than $62,040, he will get a premium tax credit. If more, he won't get any financial help but of course can still purchase whatever plan he wants on the marketplace.

One more note: couples of whatever gender who are joined in civil unions or domestic partnerships are not considered married in the eyes of the federal government. Each member of the couple must apply to the marketplace as an individual.

Got a question for our health insurance expert? Ask it here. It helps if you include the state you live in.

— Nancy Metcalf


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