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Separate and Unequal: The Effect of Unequal Access to Employment-Based Health Insurance on Gay, Lesbian, and Bisexual People


  • Michael A. Ash

    () (University of Massachusetts Amherst)

  • M.V. Lee Badgett

    () (University of Massachusetts Amherst)


Employers' standard practice of including legal spouses in health insurance is likely to place people in unmarried couples at a significant disadvantage for obtaining coverage. Data from married and unmarried couples in the Current Population Survey confirm that people with unmarried partners are two to three times more likely to lack health insurance than are people in married couples, even after controlling for factors that influence coverage. A requirement to provide the same benefits for partners as are provided to spouses would reduce the proportion of uninsured people in same-sex couples and different-sex couples by as much as 50%. We find no evidence of adverse selection. We predict that a typical employer offering domestic partner coverage will see a small increase in enrollment, ranging from 0.1% to 0.3% for same-sex partners and 1.3% to 2.1% for different-sex unmarried partners.

Suggested Citation

  • Michael A. Ash & M.V. Lee Badgett, 2004. "Separate and Unequal: The Effect of Unequal Access to Employment-Based Health Insurance on Gay, Lesbian, and Bisexual People," UMASS Amherst Economics Working Papers 2004-13, University of Massachusetts Amherst, Department of Economics.
  • Handle: RePEc:ums:papers:2004-13

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    References listed on IDEAS

    1. Dan Black & Gary Gates & Seth Sanders & Lowell Taylor, 2000. "Demographics of the gay and lesbian population in the United States: Evidence from available systematic data sources," Demography, Springer;Population Association of America (PAA), vol. 37(2), pages 139-154, May.
    2. repec:aph:ajpbhl:2001:91:11:1869-1876_4 is not listed on IDEAS
    3. Jonathan Gruber & Brigitte C. Madrian, 2002. "Health Insurance, Labor Supply, and Job Mobility: A Critical Review of the Literature," JCPR Working Papers 255, Northwestern University/University of Chicago Joint Center for Poverty Research.
    4. repec:aph:ajpbhl:2001:91:4:591-597_4 is not listed on IDEAS
    5. Christopher Carpenter, 2004. "New Evidence on Gay and Lesbian Household Incomes," Contemporary Economic Policy, Western Economic Association International, vol. 22(1), pages 78-94, January.
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    More about this item


    health; health insurance; benefits; employment benefits; health disparities; domestic partners; minorities; discrimination; gender; sexuality; sexual orientation; gay; lesbian; marriage; same-sex couples;

    JEL classification:

    • J32 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Nonwage Labor Costs and Benefits; Retirement Plans; Private Pensions
    • J38 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Public Policy
    • J71 - Labor and Demographic Economics - - Labor Discrimination - - - Hiring and Firing

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