How Marriage Equality Could Make The Country Healthier


Just days after the Supreme Court’s historic decision in favor of marriage equality, wedding planners in states that used to ban same-sex marriage are already noticing an uptick in business. But there’s a less intuitive societal benefit in store, too: Now that gay couples can wed in every state, the country as a whole may get a little healthier.

As Kaiser Health News reports, health experts are anticipating that the Supreme Court’s ruling will lead to increased insurance coverage among LGBT Americans — particularly in states that previously didn’t recognize same-sex marriages.

Most Americans get their insurance benefits through work, a reality of the health care industry that has remained largely unchanged under Obamacare. The vast majority of employers also extend health insurance to their workers’ spouses. Although the Obama administration has stressed that insurers should honor same-sex couples’ marriages, that previously only applied in the states where those unions were recognized. In other states, the decision was left up to insurers. And according to a Kaiser Family Foundation survey, fewer than half of employers in 2014 allowed same-sex partners to claim insurance benefits if they weren’t legally married.

So, when same-sex couples’ marriages gain legal recognition, more of them are able to take advantage of this aspect of the insurance market. Previous studies have found that legalizing gay marriage leads to an uptick in LGBT residents gaining employer-sponsored health plans.


Because LGBT Americans are a historically underinsured demographic group, providing them with additional avenues to get coverage could make a big difference. Advocates for marriage equality have long argued that recognizing LGBT couples’ relationships will help address some of the health disparities — like struggling to afford medication and opting to skip doctor’s appointments — that disproportionately affect gay, lesbian, and transgender individuals.

Aside from insurance benefits, there are other ways that advancing marriage equality is expected to have a positive impact on LGBT Americans’ overall health.

Partly because our society is structured around marriage, and provides married couples with a host of additional benefits that single people do not necessarily enjoy, there’s some evidence that marriage is connected to long-term health outcomes — something that researchers refer to as the “marriage advantage.”

This advantage may be even more pronounced for LGBT couples, since that legal recognition helps address some of the stress accrued by living in a society that discriminates against gay people. A large body of research has documented the fact that facing discrimination, including being denied the right to marry, takes a psychological toll on LGBT individuals. Meanwhile, same-sex couples’ mental health improves when they are permitted to legally wed.

That’s why several prominent health organizations — including the American Psychological Association, the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the National Association of Social Workers — have all endorsed marriage equality, arguing that it will boost LGBT people’s physical and mental well-being. Many of those groups praised last week’s decision.


“Today’s ruling strikes a blow to inequality and discrimination throughout the nation, and that’s good for Americans’ mental health,” Renée Binder, the president of the American Psychiatric Association, said in a statement released Friday. “The APA has a long history of supporting the rights of same-sex couples, and we have long noted that there is no scientific or medical reason to deny these couples the right to marry.”

However, challenges remain for same-sex couples. Some GOP-led states are vowing to refuse to issue marriage licenses to LGBT people. And gay couples who do not wish to get legally married may soon see their domestic partnership benefits thrown into question. Some firms are already telling same-sex couples that they need to get married or their partners will lose their health insurance.