Health care policies and tax laws unfairly penalize lesbian couples
I, and most lesbians, face the proverbial ‘catch 22′ when it comes to getting adequate, competent health care. If we come ‘out’ to our providers we take the chance it may negatively affect the treatment we’re given and if we’re not ‘out’ to our providers it may negatively affect the treatment we receive.
However, after reading an excellent article by Bonnie Osborn in the September 2009 issue of Jane and Jane Magazine entitled, ‘Feeling the Pinch: Health care inequities result in financial penalties for lesbian couples’, I was reminded that health ‘care’ is only one problem lesbians face in our current health care system.
Did you know lesbian couples are also penalized economically by the way our current health care system is set up? And that this penalizing is repeated and compounded?
For example, even though two of my sisters stay at home and don’t work, they have health care through their husband’s employers. And, even though another sister works, her husband stays home and receives full ‘spouse’ benefits (including health care, life insurance, etc.). And, I’m not even talking about all the children they have – eight between the three of them – who are covered on these various health care plans as well.
I, on the other hand, could not put my partner on my health insurance (back when I had a partner). And, my partners were never able to put me on their plans. Meaning: if at some point one of us had become unemployed and, heaven forbid, become ill, what would we do?
It becomes even more complicated when we talk about being laid off. Even if I’d at some point had the ability to add my partner to my benefits, my partner said she would have been afraid to do so. After all, if I later changed jobs, who knows if that new employer would have domestic partner coverage? Given the fact insurance coverage isn’t assured/universal, she would’ve had to go through another period of underwriting and possible exclusion. I know that’s never even a thought for straight couples.
Yes, in some places, and with some large companies, same sex partners do have access to partner benefits. But, over all, only a minority of lesbians in America have such access.
And, to add insult, the federal government taxes partner benefits as ‘taxable income’! Wow - even when we have access, we pay a price straight couples don’t: when a same sex partner is on her partner’s insurance she gets to, you guessed it: pay taxes on having the honor of such a benefit!
And, guess what? The employer is penalized too. So, good luck getting many employers to want to cover same sexed partners on their insurance plans!
Lesbians have the highest uninsured rate
Worse yet, for those who don’t have the honor of paying these additional taxes, many of these coupled lesbians remain uninsured, because they can’t afford their own insurance! Can you imagine the spouse of a straight person going through this state of affairs?
According to Osborn, a recent survey found that lesbians as a group had more uninsured than gay men and heterosexuals. In fact lesbians were almost twice as likely to be uninsured as heterosexuals.
Is it any surprise then, that lesbians, as a group, are consistently poorer than gay men and heterosexuals, especially as they grow older?
Here’s another common example of how the current system hurts lesbians financially: if your partner takes ill and needs your help, what do you do? Here’s one extreme: military personnel often wouldn’t even think of taking off to help a partner because of the attention it might put on them. They’d fear a court martial (it happens…often, and not just on The L Word).
Often then, for these individuals, benefits earned are never used. Perhaps then the couple has to pay for home health care, all out of their own pocket (if they have the resources to do so).
More common is the scenario where a partner has to use vacation time to stay home and help a same sexed partner, whereas a straight partner would be able to use sick time instead. This matters for those whose retirement benefits depend on accrued vacation time.
Or, what happens when a partner doesn’t have any sick or vacation time to use? Will her employer allow her to take ‘leave without pay’? Who can even afford to do that in today’s economy?
Osborn notes that these sorts of ‘institutionalized inequities’…
“Add up to hundreds and even thousands of dollars of financial penalties each year”.
Yikes! No wonder so many of us can never get ahead. Many of us are already being ‘under paid’ because we are women.
Why aren’t lesbians more upset about this state of affairs? Perhaps because we don’t have any energy left, after we work all the extra hours and jobs we need, to pay off these debts!
And, of course, worries about whether a doctor will provide you inferior care (because he or she doesn’t like gays or doesn’t know you are gay), and economic inequities are far from the only disparities lesbians face in today’s health care system.
Worries about whether all the legal papers we pay to draw up to protect our wishes in times of emergencies still exist. There are many instances of couples having their advance directives ignored. Tragic examples include the Lisa Pond story.
Here again, we lose financially. Setting up living wills and power of attorney documents correctly can cost hundreds, sometimes thousands of dollars. By the way, when was the last time a hospital asked a straight spouse to produce paper work to prove ‘next of kin’?
And in a cruel irony, even the two democratic presidents we’ve had in the past 20-30 years who are pro-gay have (or are) hurting us when it comes to easing these burdens:
- President Clinton’s signing of the Defense of Marriage Act (DOMA) in the 1990′s makes it illegal for the federal government to recognize legal gay relationships and allows states to deny recognition as well. In fact, according to Osborn, “recently same sex partners of laid off workers weren’t able to receive payments to help pay for COBRA health insurance that the partners of heterosexual partners received, because of DOMA.”
- President Obama has relegated DOMA to the bottom of his priority list and, when the issue has come up, has given a mixed message at best (while he has said he wants to repeal DOMA, recently, when the issue came up in a court case, his administration defended it).
In my (and Osborn’s) opinion, another of the many good reasons to support the House of Representative’s HR 3200 ‘America’s Affordable Health Choices Act’ is that it does redress a couple of the systematic problems plaguing lesbians in the current system: HR 3200 would set up a system to collect data on gays and lesbians (which would then prove the disparities and need for other reforms) and it would also stop the taxation of same sex partner health benefits.
Be sure you check out Osborn’s article. It should get you good and mad and speaking up to your congress person/persons.
BE well,
Barb Elgin, MSW, LCSW, Certified Singles Coach, is Coach Sappho: America’s Favorite Lesbian Love Coach and Matchmaker. Be sure to stop by www.coachsappho.com, pick up your FREE gifts as well as to learn about our exciting new singles club for lesbians and our community for lesbian couples.
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© Copyright 2009, Barb Elgin. All Rights Reserved. Feel free to forward this article as long as attribution remains intact.
Disclaimer: The suggestions and feedback offered in this column are but one perspective of multiple approaches to dealing with problems or challenges. Information provided in articles and advice columns should not be used as a substitute for coaching or therapy when these services are needed. None of this information should be your only source when making important life decisions. This information should not be used for diagnosing or treating a particular problem, nor should it take the place of a consultation with a trained professional. It is your responsibility to consult a professional prior to making any life decisions.
Tags: gay and lesbian health, health care disparities, Lesbian Couples, lesbian health, lesbian relationships, Women's Health, women's health care