WASHINGTON, D.C., March 19, 2014 ( – Trying to boost enrolment numbers as March 31 approaches, the Obama administration is taking new executive actions, including requiring insurance companies participating in the Affordable Care Act (ACA) to cover same-sex couples.

Bloomberg reports that the administration has ordered same-sex couples to be treated as “families” by insurers participating in the ACA exchanges. Judicial Crisis Network Chief Counsel Carrie Severino says “the move shows Obama administration is not interested in respecting a state's inherent authority in this area. They're simply pursing a political end.” 

The administration has made over a dozen changes to the ACA, some of which have been declared illegal by Republicans. Last year, the president said the health care law was “settled,” only weeks before delaying the application of the individual insurance mandate, and mere months before delaying several other components of the law. 


Last year, the Supreme Court overturned part of the Defense of Marriage Act (DOMA). Severino says that the decision “pointed to the traditional historical role in states overseeing family law. So some people saw the Windsor decision as a victory for federalism.” 

But now, according to Severino, it's clear that “their real goal is to continue a federal power grab.” 

In a blog post, the director of lesbian, gay, bisexual, and transgender at the Department of Health & Human Services (HHS) wrote that “insurance companies will not be permitted to discriminate against married same-sex couples when offering coverage.” According to Matthew Heinz, the new regulation “will further enhance access to health care for all Americans, including those with same-sex spouses.” 

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The regulation comes after a gay couple sued the state of Ohio and the federal government when they were denied a family policy under the ACA because Ohio does not recognize same-sex “marriage.” The new declaration from HHS means an insurance company that offers family policies to heterosexual couples must do the same for homosexual couples – regardless of state laws on marriage. 

This latest move “shows the administration doesn't respect state law except when it agrees with it,” says Severino. “So they are at best fair-weather federalists.” 

The insurance requirement is not the only change the administration has recently made to the ACA. Certain sick Americans will be able to take advantage of a program for another month, until the end of April, and insurers have been told to expand the number of health providers for poorer Americans in their networks. Last week, plans that pre-date the ACA were allowed to exist through 2016. 

The regulation has been imposed only days before the contraception and abortion drug mandate is to be heard by the Supreme Court. This mandate also requires coverage by insurance companies, though differences between the policies exist. 

“The big difference is that one would infringe principally on the freedom of the insurers themselves while the they affects employers,” says Severino. “But they are both instances of a one-size-fits-all approach to health care and insurance coverage.”


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