On July 8, 2010, a Massachusetts District Court held that the federal Defense of Marriage Act (DOMA) is unconstitutional, specifically in its application to health benefits. Same sex spouses may be covered by health insurance, but, under current law, the IRS has held that, due to the DOMA, health insurance cannot be offered on a pre-tax basis unless the spouse is a “dependent” under federal law. As a result, employees with same sex spouses often are treated as if the value of the health insurance was paid as additional taxable income.