Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment

Objectives. We sought to determine whether health care use and expenditures among gay and bisexual men were reduced following the enactment of samesex marriage laws in Massachusetts in 2003. Methods. We used quasi-experimental, prospective data from 1211 sexual minority male patients in a community-based health center in Massachusetts. Results. In the 12 months after the legalization of same-sex marriage, sexual minority men had a statistically significant decrease in medical care visits (mean= 5.00 vs mean=4.67; P=.05; Cohen's d=0.17), mental health care visits (mean= 24.72 vs mean= 22.20; P=.03; Cohen's d=0.35), and mental health care costs (mean= $2442.28 vs mean= $2137.38; P= .01; Cohen's d=0.41), compared with the 12 months before the law change. These effects were not modified by partnership status, indicating that the health effect of same-sex marriage laws was similar for partnered and nonpartnered men. Conclusions. Policies that confer protections to same-sex couples may be effective in reducing health care use and costs among sexual minority men.