Due to the Supreme Court ruling legalizing same-sex marriage nationwide in 2015, same-sex married couples qualify for the same benefits under the Affordable Care Act (ACA) as heterosexual couples in all 50 states. But despite that fact, many same-sex partners remain uninsured. Why? Most Americans get their health insurance through an employer-sponsored plan, and if your employer is self-insured (e.g., self-funded), they are not required to provide same-sex couple benefits.

This depends mainly on their state and whether it offers an LGBTQIA employment nondiscrimination law. This is despite a June 2020 Supreme Court ruling that people in all states can seek recourse for employment discrimination based on sexual orientation and gender identity through the federal Equal Employment Opportunity Commission (EEOC) and federal courts. View current LGBTQIA laws in each state via the Movement Advancement Project.

The Kaiser Family Foundation studied the topic and found that after the June 2020 Supreme Court ruling, about 74 percent of firms offering health insurance coverage to opposite-sex spouses also provided coverage to same-sex spouses, a substantial increase from 43 percent in 2016.

But that still leaves room for many same-sex partners to be excluded unless they utilize ACA Marketplace insurance.

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