The U.S. Supreme Court delivered a historic decision in U.S. v. Windsor1 that could have far-reaching effects on seniors, persons with disabilities, and
veterans who are married to, or plan to marry, a person of the same
gender. This post will provide an overview of the decision and how it may affect
Medicaid recipients in a same-sex marriage.
Overview of U.S. v.
Windsor:
An historical decision by the U.S. Supreme Court came down
on June 26, 2013, declaring unconstitutional a portion of the Federal law
commonly known as the Defense of Marriage Act (“DOMA”). In this case, Edith Windsor, the New York
resident and Canadian married spouse of Thea Spyer, sought relief from the
Court system when she was denied a $363,053 refund for estate taxes she paid
when Spyer died. In denying her request,
the IRS relied on Section 3 of DOMA, which defined marriage as a union between
a man and a woman. Because Windsor and
Spyer were a same-sex couple, albeit validly recognized under the laws of New
York, the Federal law disallowed benefits to them which are available to
heterosexual married couples. Here, the
benefit disallowed came in the form of estate tax relief to a surviving spouse.
In the written opinion of the Court, Justice Kennedy focused
on the long-established right of the states to determine the laws regarding
domestic relations. The Court pointed
out that New York, at the time Windsor and Spyer were married in Canada, may
not have allowed same-sex marriage within the state, but its laws protected
those who were legally married elsewhere by applying its laws equally to all
married people. It was also pointed out
that New York eventually expanded its laws to include same-sex marriage.
In addition to the fact that states have traditionally had
the role of determining what the domestic relations laws should be within their
own territories, the Court looked at the purpose and impact of DOMA
itself. The Court came to the conclusion
that because of the purpose written into the law itself along with the impact
of the law, that DOMA has the purpose “to discourage enactment of state
same-sex marriage laws and to restrict the freedom and choice of couples
married under those laws if they are enacted.”1 The Court concluded that this historical
balance between state and Federal law had been negatively impacted when DOMA,
Section 3, was enacted.
The Court ruled in this case that DOMA violated the 5th
Amendment of the U.S. Constitution because its “demonstrated purpose is to
ensure that if any State decides to recognize same-sex marriages, those unions
will be treated as second-class marriages for purposes of federal law.”1 This obviously deprives “some couples
married under the laws of their State, but not other couples, of both rights
and responsibilities.”1
Effect on Medicaid
Section 3 of DOMA, which defined marriage as only a union
between a man and a woman, applied to over 1000 federal laws, including
benefits such as Medicaid, Social Security, housing, food stamps, tax laws, benefits
due to federal employees, and veterans benefits. In some cases the application of DOMA took
away rights of same-sex married couples and, in others, it relieved them of
certain responsibilities.
It is important to
know how the overturning of this portion of the law will affect seniors. The answer is it will vary depending on what
state the couple was married in, and what state they currently reside in. While the result of overturning Section 3 of
the DOMA is far-reaching, it does not completely equalize the playing
field.
With regard to Medicaid, whether a couple may be impacted
depends on whether they are: 1) validly married; 2) living in a state that
recognizes their marriage; and/or 3) In a civil union or registered domestic
partnership and the state recognizes the relationship.
Currently 12 states and the District of Columbia recognize
same-sex marriages. In these states,
Medicaid will also recognize the marriage.
This means that the Medicaid rules will change for same-sex married
elders. The positive changes for these
elders could include an increased allowance as currently allowed for married
couples. Another advantage will be the
ability of the ill spouse to transfer assets to the well spouse without penalty
and the ability to receive some of the income of the ill spouse once qualified
for Medicaid under the Spousal Impoverishment Act provisions.
In a state that does not recognize an otherwise valid
same-sex marriage, Medicaid will also likely not recognize the union. However, some states do provide hardship
protections to a partner of a person in long term care.2
Finally, in a state that recognizes civil unions (like Illinois) or
registered domestic partnerships, a couple so joined may be treated as married by Medicaid. This is a situation which will vary based on
several factors and the tax treatment of these couples by the IRS may determine
the answer.
Impact on Other
Government Benefits
This decision will likely impact Social Security Income
(SSI) recipients, as well as veterans receiving either pension or compensation
benefits. It will likely take months
before we fully understand the impact of the Court’s decision in these areas,
as each agency determines how best to apply the decision.
Conclusion
Medicaid alone is a complex program, even for single
individuals. With the new opportunities
that have opened up for married couples of the same sex, the need for the
assistance of an Elder Law attorney is even greater. If we can help someone you know, please don’t
hesitate to contact us.
Other references:
Supreme Court Boosts Gay Marriage (The Hill – www.thehill.com)
[1] U.S. v. Windsor, 570 U.S. ___ (2013)
[2] LGBT
Organizations Fact Sheet Series: After
DOMA What it Means for You https://www.glad.org/current/post/after-doma-fact-sheets