Domestic Partner Health Insurance Benefits: The Case for Coverage

Introduction

The issue of benefits granted to domestic partners has been widely debated for several years. Employers, in the absence of clear legal guidance, have applied domestic partner insurance policies as they see fit — a situation that has created an uneven landscape penalizing millions of workers. However different the arguments and opinions, the phenomenon has attracted a growing number of supporters, leading toward an expansion of health insurance coverage for non-traditional families.

However one looks at it, the failure to grant medical benefits to the families of all employees constitutes a relevant form of discrimination — behavior that is unacceptable in twenty-first-century American society.

Background: The Scale of the Problem

According to the U.S. Census Bureau's 2000 Census, approximately 11 million people were living with an unmarried partner in the United States. This figure includes both same-sex and different-sex couples: 9.7 million Americans were living with an unmarried different-sex partner, and 1.2 million were living with a same-sex partner. Same-sex couples account for 11 percent of all unmarried partner households.

These statistics illustrate the clear necessity of regulating the medical insurance system. The 11 million Americans who have freely chosen to live outside the bounds imposed by traditional social expectations are now paying a price for those choices. Assuming that at least one member of each couple is employed, an estimated 5.5 million Americans are left without medical coverage — effectively penalized for not conforming to unspoken social norms.

The Centers for Disease Control and Prevention provides further context: 41 percent of American women between the ages of 15 and 44 have cohabited — that is, lived with an unmarried different-sex partner — at some point in their lives. This includes 9 percent of women aged 15 to 19, 38 percent of those aged 20 to 24, 49 percent of those aged 25 to 29, 51 percent of those aged 30 to 34, 50 percent of those aged 35 to 39, and 43 percent of those aged 40 to 44.

In other words, almost half of the entire female population of the United States has, at some point, lived outside of marriage and therefore did not benefit from coverage of medical expenses. The Census 2000 further reveals that the number of unmarried couples living together increased by 72 percent between 1990 and 2000, and has increased tenfold between 1960 and 2000.

Studies conducted by human rights organizations have concluded that, despite these increases, the proportion of employers offering benefits to both the worker and their domestic partner remains low. Approximately one-quarter of the American workforce is employed by a company that offers domestic partner benefits. Analysis also shows that, generally, larger and more successful companies tend to offer broader benefit packages, including domestic partner health insurance.

In sum, a large number of U.S. citizens — some 11 million — are being denied legal and medical rights based on their sexual orientation or marital status. While human rights organizations have made meaningful progress in raising awareness, the share of employers offering domestic partner benefits remains modest at roughly 25 percent, and significant work remains to be done.

Arguments Against Domestic Partner Benefits

The debate over granting medical coverage to the domestic partners of employees has numerous advocates, as well as opponents. Those who oppose such coverage tend to base their arguments on social and financial factors. Advocates of domestic partner benefits, however, contend that most of these objections can be effectively countered and that they are, at their root, driven by prejudice and social conservatism.

Supporters of domestic partner benefits note that the majority of opponents are committed social conservatives who resist the broader liberalization of definitions of marital status and family structure. These individuals generally prefer to maintain a social structure built around the traditional American family — a legally married husband and wife raising children together. Yet the family structure has been undergoing continuous change, and society, including conservatives, must learn to accept families composed of unmarried parents or same-sex couples.

Old benefit models that rely on marriage to determine eligibility for coverage ignore the dramatic changes in the American family over recent decades. In 1970, roughly 40 percent of U.S. households fit the "traditional" definition of a husband and wife living with their children, according to the U.S. Census Bureau. By 1998, only 25 percent of the nation's 102 million households matched that definition. Meanwhile, the number of Americans living in unmarried-partner households has grown large and continues to rise rapidly.

Opponents of coverage for unmarried and same-sex couples, unable to maintain the social structure they regard as the norm, effectively deny these individuals their rights as citizens — producing a clear case of discrimination. The problem lies in a limited willingness to understand and accept ways of living that differ from established norms, and the result is a serious violation of human rights. The appropriate response is not to undermine the rights of domestic partners but to educate the public about non-traditional families and relationships.

A second social argument against domestic partner benefits stems from faulty or ambiguous legislation that leaves room for competing interpretations. Opponents claim that extending benefits to domestic partners disadvantages straight, legally married employees. Advocates counter that withholding those benefits disadvantages domestic partners and, more fundamentally, violates their rights.

Regardless of perspective, the facts are clear: unmarried and gay or lesbian employees face social and financial discrimination. Domestic partner benefits represent a significant step toward equal pay for equal work. Benefits comprise nearly 40 percent of overall compensation, and many long-standing benefits are tied to the institution of marriage, effectively excluding gay and lesbian workers given that no state at the time recognized same-sex marriages. This means that without domestic partner benefits, a substantial share of total compensation was simply unattainable for gay and lesbian employees — a disparity equally applicable to unmarried heterosexual couples who choose not to marry.