Disparities in health insurance coverage and access to care are well documented between sexual minority adults and their heterosexual peers. Much less research has examined whether marital status affects access to care by sexual orientation identity. This study used data on nonelderly gay/lesbian adults (n = 1740), bisexual adults (n = 1138), and their heterosexual counterparts (n = 80,329) from the 2015–2018 National Health Interview Survey. Multivariable logistic regression models estimated the differences in health insurance status and access to care between married and cohabiting adults to single adults by sexual orientation. Compared to single adults, married adults were more likely to have private health insurance and less likely to have public health insurance regardless of sexual orientation. Married heterosexual and gay/lesbian adults were more likely to have a usual source of care and less likely to experience delayed or unmet medical care and mental health care due to cost compared to their single counterparts. We found fewer statistically significant differences between married and single bisexual adults and between married and cohabiting adults of all sexual orientations. Our study demonstrates that married gay, lesbian, and bisexual adults are more likely to have private health insurance and fewer financial barriers to care compared to their single counterparts. Given the recent recognition of legal same-sex marriage for sexual minorities, much more research is needed to document if and how marriage affects access to care and health outcomes by sexual orientation.

性少数成年人与其异性恋同龄人之间在医疗保险覆盖范围和获得护理方面的差异有据可查。很少有研究检查婚姻状况是否会影响通过性取向身份获得护理的机会。本研究使用了非老年男女同性恋者 ( n  = 1740)、双性恋者 ( n  = 1138) 及其异性恋者 ( n = 80,329）来自 2015-2018 年全国健康访谈调查。多变量逻辑回归模型通过性取向估计了已婚和同居成年人与单身成年人在健康保险状况和获得护理方面的差异。与单身成年人相比，无论性取向如何，已婚成年人更有可能拥有私人医疗保险，而不太可能拥有公共医疗保险。与单身的成年人相比，已婚的异性恋和男同性恋/女同性恋成年人更有可能拥有通常的护理来源，并且不太可能因费用而经历延迟或未满足的医疗和心理健康护理。我们发现已婚和单身双性恋成年人之间以及所有性取向的已婚和同居成年人之间的统计学显着差异较小。我们的研究表明，与单身的成年人相比，已婚的男同性恋、女同性恋和双性恋成年人更有可能拥有私人医疗保险，并且在护理方面的财务障碍更少。鉴于最近承认性少数群体的合法同性婚姻，需要更多的研究来记录婚姻是否以及如何通过性取向影响获得护理和健康结果。