Alina and Carol are married and reside in Maryland, where same-sex marriage is recognized. Alina recently had a stroke and may need nursing home in the not so distant future. How does the DOMA ruling affect Medicaid eligibility requirements for LGBT married couples and others in states that have not legalized LGBT marriage?
The answer is, it depends. Many states that have marriage equality did not treat same-sex married couples as married for many Medicaid programs, although several states have already been recognizing marriages between same-sex spouses for Medicaid purposes.
- If your state recognizes LGBT marriage: Now that the federal Defense of Marriage Act (DOMA) has been ruled unconstitutional, every state that recognizes marriages between same-sex couples will recognize their marriages for all Medicaid purposes. So, Alina and Carol in our example would be affected.
- If you are in a civil union or registered domestic partnership and your state recognizes your relationship: You may be treated as married for Medicaid purposes. We do not yet know if you will file federal taxes jointly with your partner. But if you do file taxes jointly, both of your incomes will be considered for most Medicaid income eligibility calculations, which could make you ineligible. See CNN Money’s article on “Same-sex Marriage Ruling- Financial Impact” for more details.
- If you live in a state that doesn’t recognize your relationship: You will probably not be recognized as married for Medicaid purposes, although some states may decide to provide hardship protections to a partner of a person in long term care.
For additional details, read the The Supreme Court Ruling on the Defense of Marriage Act: What It Means Fact Sheet.