Exploring “marriage penalties” in health reform
Though it didn’t get much major media attention, several small and so-called conservative outlets have been complaining that the health reform bills moving (or not) through Congress are unfair to married people. AtMP tracks news about “marriage penalties” for two reasons: first, we oppose and look for ways to solve all forms of marital status discrimination, even when married people are disadvantaged; second, we’ve found that most discussions of “marriage penalties” are actually smokescreens for even bigger marriage bonuses – policies that reward people for marrying and disadvantage unmarried people.
The latest news on health reform follows the latter trend. In a nutshell: the bill creates a subsidy for people who have to buy their own insurance; in some cases that subsidy would be lower for a married couple than for two identical unmarried people because the eligibility threshold for a married couple is less than twice that for a single person.
Before getting into the details, take a moment to savor the Heritage Foundation’s position on whether this is just:
Proponents of the Senate health care bill might argue that these marriage penalties would reach their full effect only in situations where neither partner had employer-provided health insurance. It is true that married couples with employer coverage would face less bias; however, this defense of the bill remains weak because discrimination against marriage remains discrimination even if it does not fully affect all married couples. Such discrimination is unacceptable even in a single instance.
If only they had written “marital status discrimination is unacceptable even in a single instance!” But no, discrimination that puts married couples above unmarried couples, families and individuals is just fine to them.
Heritage hints at one aspect of the smokescreen effect: married people with employer-based insurance often get to put their spouse on their health plan at a much lower cost than if the spouse had to buy her/his own coverage.
Further aspects of the smokescreen are revealed in House Speaker Nancy Pelosi’s Mythbuster analysis, and the Center for American Progress Action Fund’s Wonkroom analysis. Both link the subsidy calculation to the way the federal government calculates eligibility for subsidies generally: married couples are assumed to share all of their income and expenses, unmarried people are assumed not to share any at all. At AtMP, we believe this use of marital status often results in unequal treatment of people who are in equivalent situations – some married people don’t share, many unmarried people do, and few people share 100%.
In addition to this ‘equivalency’ problem, using marital status to determine subsidy eligibility can also create a justice problem. Subsidies are directed to people with low and moderate incomes. The amount of money a couple might save by sharing resources is often much less than the amount they stand to lose in subsidies if they expose their relationship by getting legally married. That’s why we hear from so many people with disabilities who can’t get married because marrying would make them ineligible for affordable health insurance. When will Heritage take up their cause?
It probably doesn’t make sense to treat all people in relationships as if they were isolated individuals. Instead, we’d like to see a new way of determining which people have combined their income and expenses to create an economic unit that should be subsidized or taxed at a different rate than an individual. We’re collecting suggestions on how to do that – please post yours as a comment!
