Tumin Dmitry, Kroeger Rhiannon A
Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
Department of Sociology, Louisiana State University, Baton Rouge, Louisiana, USA.
LGBT Health. 2020 Jul;7(5):264-270. doi: 10.1089/lgbt.2019.0323. Epub 2020 May 25.
We aimed to characterize couple-level private insurance coverage among same-sex and different-sex couples before and after the (OvH) decision legalizing same-sex marriage in the United States. National Health Interview Survey data were obtained for 2012-2014 (pre-OvH) and 2016-2018 (post-OvH). Coresiding couples with both partners aged 27-64 years and at least one having private insurance were included. Couple-level coverage was private for both; private for one, other coverage for another; and private for one, none for another. Secondary analysis examined whether either partner was covered by the policy of a family member in the household (partner/spouse coverage). The analysis included 69,251 couples. Ninety percent had private coverage for both partners; 5% had one partner with other coverage; and 5% had one partner uninsured. The share of same-sex couples with both partners having private coverage increased from 79% to 88% after OvH ( = 0.003), whereas it remained at 90% among different-sex couples. In multivariable analysis, this increase was explained by the increase in legal marriage post-OvH. Among unmarried same-sex couples where both partners had private coverage, the odds of one partner being covered by another's policy decreased by 61% after OvH (95% confidence interval: 35%-76%). OvH was associated with greater access to private insurance for same-sex couples and lower risk that one partner would have private insurance while another would be uninsured. Yet, partners in unmarried same-sex couples became less likely to share the same private policy.
我们旨在描述在美国同性婚姻合法化的（OvH）裁决前后，同性伴侣和异性伴侣中夫妻双方的私人保险覆盖情况。获取了2012 - 2014年（OvH之前）和2016 - 2018年（OvH之后）的全国健康访谈调查数据。纳入了双方年龄在27 - 64岁且至少一方拥有私人保险的共同居住夫妻。夫妻层面的保险覆盖情况分为：双方均为私人保险；一方为私人保险，另一方为其他保险；一方为私人保险，另一方无保险。二次分析考察了夫妻双方中是否有一方被家庭中其他家庭成员的保险政策覆盖（伴侣/配偶保险）。该分析纳入了69251对夫妻。90%的夫妻双方都有私人保险；5%的夫妻中一方有其他保险；5%的夫妻中一方无保险。OvH之后，双方都有私人保险的同性伴侣比例从79%上升至88%（P = 0.003），而异性伴侣中这一比例仍保持在90%。在多变量分析中，这种上升是由OvH之后合法婚姻的增加所解释的。在双方都有私人保险的未婚同性伴侣中，OvH之后一方被另一方的保险政策覆盖的几率降低了61%（95%置信区间：35% - 76%）。OvH与同性伴侣获得私人保险的机会增加以及一方有私人保险而另一方无保险的风险降低有关。然而，未婚同性伴侣中的伴侣共享同一私人保险政策的可能性降低了。
