Same-sex marriage refers to lawful marriage between spouses of the same sex. Same-sex marriage is legal and recognized in every U.S. state and the District of Columbia (Washington, D.C.).

As long as a same-sex couple is married in a jurisdiction with legal authority to authorize the marriage, a health insurance company that offers health coverage to opposite-sex spouses must do the same for same-sex spouses.

The federal Health Insurance Marketplace® also treats married same-sex couples the same as married opposite-sex couples in every state when they apply for premium tax credits and lower out-of-pocket costs on private insurance plans.

In Texas, same-sex marriage is legal and recognized, in line with the U.S. Supreme Court's landmark decision in Obergefell v. Hodges (2015), which legalized same-sex marriage across all U.S. states and territories. Consequently, same-sex couples in Texas have the same rights to marry as opposite-sex couples. This includes the recognition of lawful marriages performed in other jurisdictions. Regarding health insurance, companies in Texas that provide coverage to opposite-sex spouses are required to offer the same coverage to same-sex spouses. This mandate is consistent with federal regulations. Additionally, the federal Health Insurance Marketplace® applies the same rules to married same-sex couples as it does to married opposite-sex couples in Texas and every other state, ensuring equal treatment when applying for premium tax credits and lower out-of-pocket costs on private insurance plans.