No ring, no health insurance

By MarketWatch

People in unmarried partnerships are much less likely to have health insurance than married couples, and the effect is greater for heterosexual cohabitants than it is for homosexual ones, according to a recent study.

"People in gay couples are about twice as likely to be uninsured and people in opposite-sex couples are three times as likely to be uninsured (compared with) married people," said M.V. Lee Badgett, research director of UCLA's Williams Institute, a think tank that researches sexual-orientation law and public policy.

Twenty percent of people in same-sex couples are uninsured, compared with only 10% of married people and 15% of the overall population, according to the institute's study, which analyzed data from the federal Bureau of Labor Statistics and was published in the journal Contemporary Economic Policy.

Unmarried heterosexuals with partners fared even worse, with almost a third uninsured, the study found. Than means more than 3 million heterosexual couples and 300,000 gay couples potentially lack health insurance, Badgett said.

Unmarried partners are at financial risk should they face a sudden, serious illness or injury. They also may delay or forgo preventive care and resort to seeking costly emergency-room care, Badgett said. "We know lack of insurance is related to poorer care, less care and care that has to be paid for by someone else in many cases," she said.

The study's results don't surprise Nicky Grist, executive director of the Alternatives to Marriage Project, a Brooklyn nonprofit advocacy group representing people who can't marry, choose not to marry or simply haven't gotten around to it yet.

"Health insurance is probably the biggest policy-issue complaint our members and the people who contact us have," Grist said. "Overwhelmingly, it's the thing that bothers them most."

If employers universally offered domestic partner benefits to unmarried pairs, they could cut the ranks of uninsured people in unwed couples by 30% to 43%, Badgett said.

What's driving the gaps?

Lack of equal employer health coverage between married and unmarried couples is a big issue, but it doesn't fully explain the coverage gap. In fact, corporations led the way in extending health benefits to domestic partners. The private sector, and specifically large companies, began doing so more than 15 years ago, spurring some states, counties and cities to start their own domestic partner programs.

But the environment for employers to expand their health coverage is far from ideal. As health-care costs have spiraled up in the last several years, more companies are tightening their policies. Many are shifting costs to employees, asking for verification of dependents on family plans and imposing surcharges on spouses who enroll in their husband's or wife's employer-sponsored plan.

About half of Fortune 500 companies offer domestic-partner benefits. And the number of employers offering them has grown steadily, with the gap between same-sex and opposite-sex couples nearly closing, according to a survey from the Society of Human Resource Management.

In 2006, 33% of organizations offered domestic-partner benefits to same-sex partners and 32% offered benefits to opposite-sex partners, marking the second consecutive year the portions were virtually equal between gay and straight unmarried couples, according to a survey of 374 mostly large companies.

That's up from 16% of HR pros who said their firms extended benefits to same-sex couples and 26% that provided them for heterosexual couples in 2001.

Continued: Tax implications of joining partner's plan

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