A recent article released in the journal Health Affairs found that gay men and lesbians who are “partnered” (living together) are much, much more likely to be uninsured due to a lack of access to their partner’s health insurance.  In fact, partnered gay men are less than half as likely to receive health coverage through their partner’s employer.  Partnered lesbians are 75% less likely than their straight peers to have insurance through their partner’s plan.

The research was based on couples in California, a state with more protections for unmarried same-sex couples than most.  A 2005 California law mandates that all group health insurance policies and health care service plans that offer spousal benefits also extend these benefits to state-registered domestic partners.  A 2002 law requires “equal treatment of ‘dependent’ health benefits under state tax law for both public- and private-sector employees.”  However, even with these types of protection, 31% of employers don’t have to cover the partners of gay employees because of the type of insurance plans they maintain.

What impact does health reform have on this situation?  Not a lot.  Until the U.S. Department of Health and Human Services and employers expand the definition of “dependents,” same-sex partners can be treated differently.  Yes, reform is good because once it’s fully implemented uninsured partners will have access to insurance plans and health insurance exchanges without worrying about “pre-existing conditions.” But, as the article points out, subsidies for the exchange only cover people to a certain income level.  Ultimately, middle class, same-sex couples will have to pay more than their straight peers because a civil union or a registered domestic partnership is not the same as a marriage.

Interestingly, the study found no evidence to suggest that employers in California were actively discriminating against gay employees, but they do point to coverage rules that inherently favor legally married, straight couples.  This is further exaggerated by the higher federal tax burden that employees face when enrolling their partners under their health plans.  As I mentioned yesterday, new research from the Williams Institute that found that this cost gay couples an average of over $1,000 per year in taxes alone, and this is certainly not the only place these inequities exist.

The article’s conclusion pretty much sums it up:

Achieving the goal of universal coverage depends, in part, on remedying inequities in state and federal marriage-related rules. In our efforts to rebuild economic strength and security in the United States, it is important to consider the role of public policies in unfairly disadvantaging some minority classes of individuals and their families, and to recognize society’s interest in righting the balance of who bears those costs.

The research was conducted by UCLA and the Lambda Legal Defense and Education Fund.

The real question is what message politicians and pundits will take out of the Massachusetts surprise. (As of this writing, we do not know whether that surprise will be a near-loss for Democrats or a GOP triumph.) Many argue it means Democrats should run from reform. But that would not just be disastrous for American health care. It would misread the results and ignore the lessons of history. Not passing health reform would guarantee that dire predictions about the Democrats’ fate will come true.

I think they’re right. Once the process is in the rearview mirror and the elements that the public supports are enacted, the important thing will be that the Democrats did something and it improved lives. Scale isn’t nearly as important politically as success or failure.

If there is a lesson in the Massachusetts vote, it is this: pass a bill. The nation needs reform. Democrats need an accomplishment. And Democratic activists and voters need a new cause: fixing reform, not abandoning it.

I’m naturally an optimist, but here is why I say this.  Yes, this has the potential to derail many of Obama’s plans, including health reform.  Oddly though, it seems that people have already forgotten what this administration has faced to date.  First, we relied on moderates like Susan Collins, Olympia Snow and Arlen Specter for passage of the stimulus.  Then Specter switched parties which gave the Democrats “60″ votes.  How much good did that do?

When came time to debate health reform we faced Olympia Snowe’s central role in getting a bill out of the Finance Committee which fell short of what progressives had outlined.  Then what happened?  Democrats got Liebermaned (I think I’m coining that).  After that?   We were put in a full (Ben) Nelson.  As Matt Yglesias points out, even Democrats who didn’t cause problems for health reform obstruct other progressive policies.

My point is only that having 60 Senators caucusing with the Democrats has produced some less than desirable results.  I get the incredibly sad irony that it was Kennedy’s seat that is torpedoing the (relatively) comprehensive health reform we thought we had.  It’s also tough to see exactly what reforms will end up passing.  I’ll leave that to people who have a better whip count.  It will inevitably be less than I want, but it should still be something.

One other observation:

I’ve heard a lot of grumbling now that issues of LGBT rights have no chance of passing now.  I have to wonder though, what did the 60 vote supermajority get us before?  The Hate Crimes Bill passed with bipartisan support because it was folded into the defense authorizations bill.  Other than that?  We’re not looking at much success.  A repeal of Don’t Ask, Don’t Tell?  Not passed.  The Employment Non-Discrimination Act?  Still waiting.

My point isn’t to say that it can’t get worse, so we shouldn’t bother.  My point is to say that we need to stop thinking of and describing some of these issues as “progressive” issues that will only pass when Democrats can drive it through.  The repeal of DADT is supported by a majority of Americans.  Further, the Employment Non-Discrimination Act has bipartisan support in the Senate and House.  We may not get the leadership we’d hope for from the White House, should they decide to play it safe for the midterms, but it is not unfathomable to imagine it being pushed through without White House leadership.  Sure, support from Democrats is often easier than Republicans, but we shouldn’t completely write off all Republicans.  The pressure needs to be felt by Reid and Pelosi.  Will we get a repeal of the Defense of Marriage Act?  No.  Could movement be made on DADT or ENDA?  I don’t think we should give up.

Full disclosure: before I wrote that last post, I hadn’t seen the end of President Obama’s speech.

There has been no better eulogy for Senator Kennedy than Obama’s remarks tonight.

Obama’s closing lines:

“I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road, to defer reform one more year, or one more election, or one more term.

But that is not what this moment calls for.

That’s not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it’s hard.

I still believe that we can act when it’s hard. I still believe we can replace acrimony with civility and gridlock with progress. I still believe we can do great things and that here and now we will meet history’s test, because that’s who we are. That is our calling. That is our character.”

THOUSAND OAKS, Calif. – California authorities say a clash between opponents and supporters of health care reform ended with one man biting off another man’s finger.

Ventura County Sheriff‘s Capt. Frank O’Hanlon says about 100 people demonstrating in favor of health care reforms rallied Wednesday night on a street corner. One protester walked across the street to confront about 25 counter-demonstrators.

O’Hanlon says the man got into an argument and fist fight, during which he bit off the left pinky of a 65-year-old man who opposed health care reform.

A hospital spokeswoman says the man lost half the finger, but doctors reattached it and he was sent home the same night.

She says he had Medicare.

O’Hanlon says the attacker fled but authorities have a good description.

I’m sorry, but a gesture is not enough.  A memorandum giving equal rights in terms of benefits for a small subset of gay men and women should not pass as compensation for a wildly insulting and harmful memo comparing gay marriage to incest from someone who has claims to be a great champion of gay rights.  This should have been something released on any given Wednesday, not in response to an administration screw up.

I’m not well read on all of these issues yet, but will post more later–from what I know of the Justice Department brief it’s appalling.  Really difficult to believe that Obama supports it, but he hasn’t spoken against it yet which is seemingly far worse than it being released under his radar.  I don’t excuse a brief that is released without the White House knowing, but its almost understandable.  However, not responding to the outrage (or anticipating that this is an issue that should be carefully monitored) is completely unacceptable.

All of that said, Steele went way beyond a lack of empathy on Saturday when argued that same sex marriages shouldn’t be legalized because it would cost small business.

Republicans can reach a broader base by recasting gay marriage as an issue that could dent pocketbooks as small businesses spend more on health care and other benefits, GOP Chairman Michael Steele said Saturday.

Steele said that was just an example of how the party can retool its message to appeal to young voters and minorities without sacrificing core conservative principles. Steele said he used the argument weeks ago while chatting on a flight with a college student who described herself as fiscally conservative but socially liberal on issues like gay marriage.

Steele, who is proven time and again that he is beyond out of touch, clearly has no sense of what it means to be “socially liberal.”  This is about equality and fundamental fairness.  People who support gay marriage don’t suddenly sacrifice their sense of fairness and equality because it has implications.  People who support equality believe that the relationships between two people of the same sex should be valued as much as heterosexual couples.

Finally, if he’d get on the band wagon for health care reform, rather than trying to be an obstructionist, perhaps health care coverage would be more affordable and those small businesses could handle the cost of covering gay couples.  Looks like signing on to the full Democratic agenda could solve all of Steele’s problems.

I immediately had three thoughts:

1. His argument boils down to the fact that we should keep people smoking for the tax revenue.  Is this really the country we want to be?  Yes, it’s your choice to smoke, but should we want more people to live shorter and unhealthier lives simply for a revenue stream?
2. I don’t feel bad for people who will have to pay more for their cigarettes.  As far as I’m concerned, by purchasing cigarettes, you are accepting the tax burden—I don’t consider this raising taxes on the poor, I consider it an investment in the future health care of smokers. Especially if such a high percentage of these people are low income, we’ll (as a nation) likely be paying for their health care.
3. He seems to be saying that they smoke because they are lower income, when in fact we could have a case of chicken and the egg.  One could argue that both a lower income and a tendency to smoke may come from another common factor like level of education (this is a statistical fact, I’m in no way saying if you smoke you’re unintelligent–even Obama was[is?] a smoker).  Or perhaps they are lower income because they spend massive amounts of money on their habit.  One article cites $5 as the average cost for a pack of cigarettes.  If you smoke a pack a day, that’s $1,825 per year for just the cigarettes, not including any indirect expenses (see this article for a fuller picture of the cost of smoking).  For a little perspective, 20% of Americans made under $19,000 in 2006.  A smoker in that 20% of Americans is spending 10% of their annual income on cigarettes.