By Kathryn Doyle
4:33 PM EDT, September 27, 2013
NEW YORK (Reuters Health) - Kids with same-sex parents are less likely to have private insurance than those with opposite-sex married parents, according to a new study.
But some of those differences go away when states allow same-sex marriage or civil unions, researchers found.
The connection isn't surprising but is important, lead author Gilbert Gonzales, from the University of Minnesota in Minneapolis, said. Evidence links insurance coverage with better general health among children, including fewer deaths, he told Reuters Health.
The study also showed kids with unmarried opposite-sex parents are less likely to be privately insured than those with married opposite-sex parents.
Gonzales and his coauthor Lynn Blewett looked at data from the nationwide American Community Survey collected between 2008 and 2010. The survey included roughly 5,000 children and teenagers with same-sex parents, 1.4 million with married opposite-sex parents and 100,000 with unmarried opposite-sex parents.
The researchers found 78 percent of children with married opposite-sex parents had private health insurance, whereas 63 percent of children with dual fathers and 68 percent of those with dual mothers were covered by similar plans.
"A 10-percent difference is large enough to raise some concerns, especially when health insurance is important to children's access to preventive and medical care," Gonzales said.
The difference was smallest in states where same-sex marriage and second-parent adoptions are legal, like California, Massachusetts and Vermont.
Children of dual mothers were just as likely to have private insurance in those states as kids of opposite-sex married parents, although for dual fathers there was still a notable disparity.
"Private insurance is mostly insurance from their parents' employers, and most Americans are covered by private employer-based coverage," Ninez Ponce of the department of health policy and management at the UCLA Fielding School of Public Health in Los Angeles, said.
"If there is a gap in private insurance, then this means that there may be eligibility rules, or tax incentives at play that differentially advantage the children of opposite-sex couples from same-sex couples," Ponce, who was not involved in the study, told Reuters Health.
About 60 percent of U.S. children are covered by private insurance and 30 percent by public insurance like Medicaid or the Children's Health Insurance Program (CHIP), according to the State Health Access Data Assistance Center.
The new results appear in Pediatrics. The journal is published by the American Academy of Pediatrics, which endorsed same-sex marriage in March.
Christopher Carpenter, a professor of economics at Vanderbilt University in Nashville, Tennessee, called the study "critically important." That's because it is the first look at coverage disparities for children, not adults, in same-sex families.
He said the proportion of gay and lesbian couples with children will only be increasing in the future.
Therefore, "this study is fundamentally important for documenting the first evidence that children in these households face lower health insurance coverage rates - which could translate to reduced access to care and poorer health," Carpenter told Reuters Health in an email.
The findings help make the case that same-sex marriage could improve overall well-being for gay and lesbian households, he added.
More and more families of all kinds will likely get private insurance in the next few years under the Affordable Care Act, Gonzales said.
"More middle-class and working families will find themselves receiving subsidies and enrolling in private health insurance through the online marketplaces," he said.
"In addition, the Supreme Court's striking down of the Defense of Marriage Act (DOMA) this past summer will make it easier for gay and lesbian workers to add partners and their children to employer health plans."
SOURCE: http://bit.ly/1gA08f3 Pediatrics, online September 16, 2013.
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