Three California public employees and their same-sex spouses were allowed to challenge the constitutionality of Code Sec. 7702B(f) because it interferes with their ability to purchase long-term care insurance through their employer. Participants in qualified long-term care programs can deduct the premiums as medical expenses. In addition, the benefits received are not taxable. Code Sec. 7702B(f) denies this favorable tax treatment to state-maintained long-term care insurance plans if they provide coverage to same-sex spouses.
Although "spouses" are eligible for coverage under Code Sec. 7702B(f), the Defense of Marriage Act (DOMA) defines spouse to mean a "person of the opposite sex who is a husband or a wife." It also defines marriage as "a legal union between one man and one woman as husband and wife." So, CalPERS refuses to allow lawfully married same-sex couples to participate in its long-term care program because of DOMA.
The government conceded that DOMA departed from the federal government's usual practice of accepting marriages recognized by state law and the court found that the individuals sufficiently claimed that the laws at issue have no rational relationship to a legitimate governmental interest.