KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Those In Gay Marriages Set To Receive New Federal Benefits

The federal government on Thursday issued rules on the federal benefits that gay Americans and their same-sex spouses can expect to receive. HHS said Medicare will allow all beneficiaries access to care in a nursing home where their spouse lives. A ruling from Treasury and the IRS also has implications for the health law, combining gay spouses' incomes in determining eligibility for the Medicaid expansion and subsidies to buy coverage in online marketplaces. 

The New York Times: Gay Marriages Get Recognition From the I.R.S.
Separately, the Health and Human Services Department said Thursday that Medicare would extend certain key benefits to same-sex spouses, "clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives." But federal agencies are not moving in lock step. Instead, they are creating a patchwork of regulations affecting gay and lesbian couples -- and may be raising questions about discrimination and fairness in the way that federal benefits are distributed. Medicare and Treasury officials have said they would use a "place of celebration" standard for determining whether gay couples are eligible for benefits. That means same-sex couples would receive benefits as long as they are legally married, regardless of where they live (Lowrey, 8/29).

Kaiser Health News: Capsules: IRS Ruling On Same-Sex Couples Has Implications For Health Law
The decision from the Treasury Department and the Internal Revenue Service means that the income of legally married same-sex couples will be considered in determining eligibility for enrollment in the health law's Medicaid expansion and for subsidies to purchase coverage in the law's online marketplaces, or exchanges (Carey, 8/30).

Los Angeles Times: IRS, Treasury Will Recognize Same-Sex Marriage Across State Lines
The change in policy follows the Supreme Court's decision in June overturning a key provision of the Defense of Marriage Act that barred the federal government from recognizing same-sex marriages for purposes such as insurance benefits, immigration and tax filings. … "Today's announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court's decision and to ensure that gay and lesbian married couples are treated equally under the law," Health and Human Services Secretary Kathleen Sebelius said (Koseff, 8/29).

The Hill: HHS Expands Medicare Options For Same-Sex Couples
The Health and Human Services Department took initial steps Thursday toward complying with the Supreme Court's ruling striking down part of the Defense of Marriage Act. The HHS lifted restrictions on nursing home care for same-sex couples, which had been imposed by DOMA's definition of marriage as a union between a man and a woman (Baker, 8/29).

The Washington Post’s Wonk Blog: The IRS And Medicare Will Now Recognize Same-Sex Marriages. All Of Them.
It's still not all federal government roses for these couples. Social Security uses a place of residence rule, and has issued instructions to personnel to deny claims for spousal benefits from same-sex couples living in states where such marriages are not recognized. But the overall trend is toward a federal government that offers benefits to as expansive a set of same-sex married couples as possible (Matthews, 8/29).

Modern Healthcare: HHS Extends Equal Coverage To Same-Sex Advantage Beneficiaries In Skilled-Nursing Facilities
All beneficiaries in Medicare Advantage plans will now receive access to equal coverage when it comes to care in a skilled-nursing facility where their spouse lives, regardless of sexual orientation, HHS announced Thursday. The guidance specifies that certified married same-sex couples would be eligible for this equal coverage and care even if they reside in a state that does not legally recognized their marriage (Johnson, 8/29).

The Associated Press: Judge: VA Can't Deny Benefits To Lesbian Army Vet
A judge in Los Angeles ruled Thursday that a lesbian Army veteran and her spouse should be entitled to disability benefits given the recent Supreme Court ruling that struck down part of the Defense of Marriage Act. U.S. District Judge Consuelo Marshall said that a federal code defining a spouse as a person of the opposite sex is unconstitutional "under rational basis scrutiny" since the high court's decision allowing legally married gay couples the right to health care benefits (8/30).

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