HIPAA’s Privacy Rule allows healthcare providers to share relevant health information with family members, which now explicitly includes same-sex spouses. The provision considers that spouses often play a role in a patient's care and need to be able to participate fully in healthcare discussions. The rulings in cases like Obergefell and Windsor provide a framework for including societal changes and diversity within the definitions of HIPAA.
The United States v. Windsor case decided in 2013, struck down provisions of the Defense of Marriage Act (DOMA), which allowed the government to recognize same-sex marriages performed in states where they were legal. The ruling set a precedent by affirming that denying federal benefits to same-sex couples was unconstitutional.
In 2015, Obergefell v. Hodges built upon the groundwork of the Windsor case and expanded the recognition by declaring that same-sex couples have a fundamental right to marry under the Constitution's Due Process and Equal Protection Clauses. The decision required all states to issue marriage licenses to same-sex couples and recognize marriages performed in other jurisdictions. This eliminated the legal barrier that marginalized LGBTQ+ individuals.
Following Windsor, the Department of Health and Human Services (HHS) noted that HIPAA’s Privacy Rule recognizes legally married same-sex spouses as family members. The clarification grants them the same rights as opposite-sex spouses regarding access to protected health information (PHI). It means that healthcare providers are permitted to share a patient's PHI with their same-sex spouses.
This recognition applies universally, regardless of whether the couple resides in a jurisdiction that acknowledges their marriage. It should be noted that questions remain about whether same-sex spouses qualify as “personal representatives” under HIPAA. It could affect their ability to make healthcare decisions on behalf of their partners. The Office for Civil Rights has indicated that it intends to clarify this aspect further.
The HIPAA Privacy Rule allows healthcare providers to share PHI with family members involved in a patient’s care, including spouses. Under specific conditions, healthcare organizations can disclose PHI to a spouse without requiring explicit consent from the patient if the spouse is involved in the patient’s care or if the patient is present and does not object to the disclosure.
The provision allows spouses to participate in healthcare decisions, access medical information, and support each other during treatment processes. Protections extend to genetic information, prohibiting health plans from using the information for underwriting purposes.
Case law in legislative interpretation provides judicial guidance on the intent and application of statutes.
The term family member is defined to include:
HIPAA prohibits health plans from using or disclosing genetic information for underwriting purposes.