Because unmarried opposite-sex couples can become eligible for family benefits by marrying, and employers remain free to offer family health care benefits to any other family members, including aunts, nieces, siblings, or cousins, the only family members whom the Public Employee Domestic Partner Benefit Restriction Act bars from receiving family health care benefits are the domestic partners of lesbian and gay workers. The Act therefore imposes on gay and lesbian employees' families alone the burdens of being uninsured or underinsured: financial hardship, health-related anxiety, stress, and medical risk.

Many states, like Michigan, are facing issues pertaining to benefits for same-sex partners. In November the ACLU filed a brief [JURIST report] against a similar bill in Montana after the state approved a law that denied partnership benefits to same-sex couples. They argued that the new law violates of the Montana Constitution. The US Court of Appeals for the Ninth Circuit [official website] ruled [JURIST report] in September that a bill [text, PDF] rescinding health benefits for same-sex couples in the public sector is against the equal protection clause of the Arizona Constitution.