When the U.S. Supreme Court announced Friday it would decide if the Constitution permits states to ban same-sex marriage, it gave hope to LGBT couples who want the same rights as heterosexual couples. It’s legal for gay and lesbian couples to marry in 36 states and Washington, D.C. That number could grow in June, when the Supreme Court is scheduled to rule whether marriage rights apply equally for all citizens or can be restricted by the states. (Oral arguments will take place in April.) In the meantime, LGBT couples struggle with inconsistent laws across the country. 

Hospital Visitation

In 2010, President Barack Obama called on the Department of Health and Human services to create a rule prohibiting hospitals and medical centers from stopping gay and lesbian couples from visiting their partners because of relatives-only policies.

“There are few moments in our lives that call for greater compassion and companionship than when a loved one is admitted to the hospital,” the president said in a memo to the department, quoted by CNN. “Yet every day, all across America, patients are denied the kindness and caring of a loved one at their sides.”

The rules went into effect in 2011, with the federal government restricting Medicaid and Medicare funding for any hospitals that didn’t participate.

There are still reports of men and women being arrested at a spouse’s bedside for refusing to leave when hospital staff didn't acknowledge their partnership. Roger Gorley was handcuffed and forcibly removed from his ill partner’s bedside, despite having power of attorney.

Tax Breaks

The U.S. Treasury Department and Internal Revenue Service announced in 2013 that all same-sex couples who are married are eligible for federal tax benefits.

“Committed and loving gay and lesbian married couples will now be treated equally under our nation’s federal tax laws, regardless of what state they call home,” Chad Griffin, the president of the Human Rights Campaign, told the New York Times. “These families have access to crucial tax benefits and protections denied to them under the discriminatory Defense of Marriage Act.”

Yet the lack of consistent state laws has made the various federal tax regulations a kind of patchwork of legislation. Married couples still have no choice but to file as individuals in the 14 states where same-sex marriage is illegal, for instance, and the Social Security Administration may have further confused things by using a “place of residence” to determine the level of spousal benefits.

Birth Certificates

The Supreme Court will decide on the case of four Ohio couples who are demanding that the state, which does not allow same-sex marriage, recognize their out-of-state marriages by allowing them to be listed as parents on their children’s birth certificates. Two widowed men are aiming to be listed as husbands on a death certificate.

“All of the [couples] seek an order that will establish for children and parents in families established through same-sex marriages the same status and dignity enjoyed by children and parents in families established through opposite-sex marriages,” said the suit filed by Cincinnati lawyer Alphonse Gerhardstein in 2013.