Health Care: A Lesbian Mother’s Sudden Passion for Reform

As the author found out, the rules of our broken health care system are so baroque, something entirely unexpected can trip you up, threatening family finances. She asks us to help President Obama sell the nation on reform this week.

They say parenthood changes you in ways you’d never expect. As a gay parent, I’ve found that to be doubly true in at least one particularly surprising way: Being a parent has turned me into a warrior—a warrior for health care reform.

To be honest, before I had my child I was hardly riveted to the ups and downs of this most recent version of our national health care debate. I’ve been pro-universal health care for my entire adult life—in part, perhaps, because I spent half of my 20s without any health insurance to speak of—but watching the pols jaw their way around the details of this one was more than I could bear. The lines drawn had become so partisan that all I could do was shake my head and hope for a fair outcome. Until, that is, I found myself facing the gated community that is American health care from the outside looking in.

Here’s what happened: I got pregnant. I had a baby. And—for reasons both practical and personal—I stopped working for an employer full-time. Which was when I learned everything I needed to know (and more) about how gays and lesbians remain separate and utterly unequal in the eyes of the law when it comes to obtaining health insurance for their families.

Over the past decade, more and more companies have begun offering their employees domestic partner benefits—ostensibly an opportunity for unmarried couples (of the same or opposite sex) to share in an employer’s health care plan as legally married couples do. As of 2008, in fact, 285 of Fortune magazine’s top 500 companies were offering employees this option. And late last summer, after some hard lobbying on my partner J’s part, her company joined their ranks, announcing that DP benefits would now be available to all employees, and their families, as well.

J and I celebrated and felt blessed to be in a position where it seemed we could make decisions for our growing family just like our heterosexual friends. When it came time to read the not-so-fine print, however, we were stunned to realize that “equal access” was a complete distortion of what these domestic partner benefits offered. Yes, we could all be on the same plan if need be, but unlike our heterosexual, married friends, we would be taxed—and heavily—for the privilege.

Few people—gay or straight—realize that there are significant tax consequences that attach to DP benefits. As one human resource professional explained it:

Domestic partner benefits may be taxed differently than married couples benefits. In general, no tax consequence follows for the family when an employer provides health insurance for the employee’s spouse and legal dependents. However, an employee whose domestic partner receives health benefits would normally include the cost of those benefits as taxable income.

In other words, if you’re a married heterosexual and put your family on your company’s health plan you get the double benefit of health insurance coverage and freedom from taxation on the value of that plan, although it’s technically “income” by IRS standards. But if you’re unmarried, you get no such forgiveness by the IRS—the value of that health care coverage for your partner (and any pre-tax contribution to the plan) is instead calculated as income by the IRS and summarily taxed.

Even in those few states that allow gay and lesbian couples to wed the situation is little better, since those marriages aren’t recognized by either the federal government or the IRS. So claiming the benefit means seeing significantly less money in your paycheck than your married peers—so much less, in many cases, as to make the possibility of choosing domestic partner benefits completely untenable.

Many unmarried straight couples take one look at the difference the tax burden makes in their take home pay and hasten themselves to the county clerk’s office or chapel, to make their partnerships legal. But for families like mine, no such option exists whether or not our state allows us to marry. The federal Defense of Marriage Act (1996) made sure of that by “[rendering] invalid most state or local tax provisions for gay, lesbian, bisexual and transgender families for the purpose of federal taxes.”

Watching a significant percentage of J’s take home pay disappear into the ether every two weeks simply because we’re gay is a difficult pill to swallow—especially when we know that our married friends get to use those same dollars for the care and feeding of their own families. But at least we are in a position to attempt to choke it down. We shouldn’t have to, but we do, because our child, like every other child, deserves quality health care and because even the troubling amount we are being taxed pales in comparison to how much it would cost us to buy insurance on the open market for myself and an infant. Our child will eventually be covered under J's policy without extra tax, but only after a long delay for an expensive adoption process that can be complicated—and sometimes impossible—depending on state laws.

Most families, gay or straight but somehow “untraditional” in the eyes of the federal government, don’t necessarily have these options. Either they make too little money to afford the tax on DP benefits, or they work for companies that offer no benefits at all. They live in a netherworld where they are deemed too rich to qualify for federal programs but remain too poor to afford to pay for private insurance on their own. What happens if one of them joins the 9.7 percent of Americans who are now unemployed thanks to this recession? Or when a child comes along and one of them has to step away from a career and the health insurance that might come along with it?

Federal recognition of gay marriage would, of course, be one solution to the problem—but it would only be a half measure in this case. It would do nothing for the partner of anyone whose job didn’t already come with health benefits.

The solution that hits the nail squarely on the head is a health care system that offers coverage to all Americans, on equal terms, and certainly not as a function of sexual orientation, marital or class status. While gays, lesbians and unmarried heterosexuals face a specific burden in relation to their access to insurance, they represent just a sliver of the population whose lives could be improved—and in some cases saved—by a health care system that covers not just some of the people some of the time, but all of the people, all of the time.

This week, President Obama is scheduled to address a joint session of Congress to encourage the passage of legislation that is our best shot yet at reforming our health care system and making it more inclusive. It’s not perfect, but it’s a start. Now is the time for all of us—gay, straight or otherwise—who believe in equity and justice to do more than just watch and wait. Call your senator. Tell your friends and family to do the same. My family’s future, and yours, depend on it.