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The Supreme Court and Same-Sex Marriage: What's at Stake for Older Gay Couples

How do Medicaid long-term care benefits compare for heterosexual and same-sex married couples?
They're completely different. When a heterosexual spouse becomes seriously ill or incapacitated and requires long-term care, Medicaid policies are designed to prevent the healthy spouse from being impoverished by the high costs of such care. If one spouse enters a nursing home, for example, the other spouse can keep the couple's home, household goods and one car. Same-sex couples don't have this protection. A same-sex spouse risks losing it all, depending on who officially owns the property.

Do Medicare benefits differ for heterosexual and same-sex couples?
They can. Eligibility for full Medicare benefits is based on a person's employment history or, in some circumstances, on the employment history of his or her spouse. Because of DOMA, this option is not available to same-sex couples.

President Obama ended the "don't ask, don't tell" policy that prevented gay people from serving openly in the military. Didn't that make the same-sex spouses of veterans eligible for benefits?
No. Heterosexual spouses of veterans qualify for bereavement counseling, death pensions, home loan guarantees and even a burial flag. They can also be buried beside a spouse in a veterans cemetery. That still isn't so for same-sex spouses.

How does the California case that's also before the court come into play?
If the court finds DOMA unconstitutional, the federal government can no longer deny benefits to gay and lesbian married couples. But who's allowed to get married has, for the most part, been left up to each state to decide. That's why the court's ruling in the California case is so important.

What rulings could the justices make in the California case?
The justices have several options. Here are a few:

  • Californians didn't violate the U.S. Constitution when they chose to prohibit same-sex couples from marrying.
  • Californians violated the Constitution, but for reasons that only apply to that state.
  • No state can prevent same-sex marriages.

Don't some states already allow same-sex marriages?
Yes. Same-sex marriage is now legal in Connecticut, Iowa, Maine, Maryland, Massachusetts, New Hampshire, New York, Vermont and Washington, plus the District of Columbia. It becomes legal in Delaware July 1, and Rhode Island and Minnesota Aug. 1. The laws in these places won't be affected by the court's ruling in the California case.

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