© 2023 University of Missouri - KBIA
Play Live Radio
Next Up:
0:00 0:00
Available On Air Stations
KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Marriage Equality Could Mean More Equal Access to Healthcare

Rebecca Smith
Laura Zinszer (left) and Angie Boyle share a kiss after being issued the first marriage license in Columbia on June 26.

Boone County Recorder of Deeds Nora Dietzel said June 26 was a busy morning for her.

That’s when the US Supreme Court announced their decision requiring all states to issue marriage licenses to same-sex couples. Dietzel said she got a call almost immediately from one couple who’d had their application on file for almost a year.

“The moment that I read the Supreme Court ruling on the computer, my phone was ringing and it was them wanting to know if they could come down,” Dietzel said.

45 minutes later, Angie Boyle and Laura Zinszer were holding their marriage license.

“We're relieved to be able to have this piece of our life be permanent,” Zinszer told KBIA’s Sara Shahriari back in June.

“And all the benefits that come with marriage,” added Boyle.

One spousal benefit that LGBT Missourians will now be able to access is employer-sponsored health insurance.

According to a 2012 report from the Missouri Foundation for Health, less access to employer-sponsored coverage has contributed to poorer health outcomes and fewer doctor’s visits among the LGBT population.

And Andrew Shaughnessey, Manager of Public Policy for Missouri LGBT advocacy organization PROMO, said same-sex couples will see other benefits from sharing health coverage.

“Immediately, your premiums go down and immediately you get access to the opportunity to go to the doctor and not fear having a huge medical bill,” Shaughnessey says.

“Not having health insurance, you fall in the slope where you might not go and seek care. And so we see a lot of LGBT Missourians who are foregoing care.”

So far the Boone County Recorder of Deeds office has only issued 17 licenses to same-sex couples, and with few cases across the state, it’s hard to estimate the decision’s impact on LGBT health. But other states that recognized same-sex marriage before last month’s decision could give Missouri an idea of what’s to come.

“We found that in the year after New York adopted the marriage equality act, employer-sponsored insurance went up for men and women in same-sex relationships," says Gilbert Gonzales, a PhD candidate at the University of Minnesota School of Public Health.

"Interestingly enough Medicaid [coverage] went down in those two groups."

In a recent publication in the Journal of the American Medical Association, Gonzales looked at health insurance coverage among same-sex couples in New York before and after the state passed its 2011 Marriage Equality Act.

He found that after same-sex marriage was legalized, more than 5 percent more women and 6 percent more men in same-sex relationships reported having employer-sponsored health insurance. The rate of individuals who reported not having coverage also went down in both categories.

And while New York may be a very different state, Gonzales says there will be changes to the way LGBT Missourians can access care.

“Married same-sex couples can enter the health insurance marketplaces, whether its Healthcare.gov or the state-based marketplaces together and they'll be able to be determined for Medicaid together if they are married."

Hope Kirwan left KBIA in September 2015.
Related Content