Not Married, No Health Insurance

Compared to married couples, unmarried couples are far more likely to not have health insurance. People in unmarried partnerships are much less likely to have health insurance than married couples, and the effect is greater for heterosexual cohabitants than it is for homosexual ones, according to a recent study.

Unmarried partners are at financial risk should they face a sudden, serious illness or injury. They also may delay or forgo preventive care and resort to seeking costly emergency-room care.

Lack of equal employer health coverage between married and unmarried couples is a big issue, but it doesn't fully explain the coverage gap. In fact, corporations led the way in extending health benefits to domestic partners. The private sector, and specifically large companies, began doing so 15 years ago, spurring some states, counties and cities to start their own domestic partner programs.

But the environment for employers to expand their health coverage is far from ideal. As health-care costs have spiraled up in the past six years -- premiums have jumped 87% since 2000, according to the Kaiser Family Foundation -- more companies are tightening their policies. Many are shifting costs to employees, asking for verification of dependents on family plans and imposing surcharges on spouses who enroll in their husband's or wife's employer-sponsored plan.

Fortune 500: 50% offer domestic-partner health insurance programs

Half of Fortune 500 companies offer domestic-partner health insurance programs. And the number of employers offering them has grown steadily over the past five years, with the gap between same-sex and opposite-sex couples nearly closing, according to a survey from the Society of Human Resource Management.

Still, the majority of employers don't offer domestic-partner health insurance benefits. Even among those that do, some people may not feel comfortable taking advantage of them. They may not want to identify themselves as being in a nontraditional relationship for fear of social disapproval or negative consequences on the job.

Even if domestic-partner benefits are available, people in unmarried unions often have to consider the tax implications of joining a partner's plan -- health insurance is taxed as income among non-spouses -- and compare that to the cost of buying an individual health plan.

The study also suggested differences in age, education level and income between unmarried heterosexual couples and married couples may play a role in explaining that coverage gap. Married couples are more likely to be older, have children and have higher incomes with which to purchase individual health insurance if they find themselves without employer-sponsored health care.

Health Insurance for Children

Tens of thousands of middle-class families could get help paying for health insurance for their children if a proposal by Gov. Janet Napolitano is adopted this year by the Legislature.

The AZ governor wants to expand a low-cost state health insurance program to include children of families up to 300 percent of the poverty level, or about $60,000 a year for a family of four. She also wants to increase out-reach efforts to get more eligible families enrolled in the state health plan in hopes of reducing the number of uninsured children in the state.

The proposal to expand KidsCare, which is likely to meet strong resistance from some conservative lawmakers, is expected to cost about $6 million next year and is part of the budget plan Napolitano released Friday. It comes as several states move toward programs to insure all children or create universal health care programs for their entire population.

Tax to Pay Health Insurance

Of course, history shows that this proposed cost if this tax to pay health insurance will likely be just a small portion of the actual cost the tax payer will actually pay. If states try to foist the cost onto business, they will find this just one more reason to relocate to a "red" state, including Atlanta, Georgia, where cost of operations is likely lower.