For same-sex couples, whose marriages aren't recognized by the federal government, the costs of getting health care add up quickly.

Mike Bosia and Steven Obranovich, of Hardwick, Vt., were married three years ago after Vermont legalized same-sex marriage. As Bosia's spouse, Obranovich is entitled to health insurance through Bosia's employer,Saint Michael's Collegein Colchester.

But that coverage comes at a cost.

The couple estimates that they have had to pay $4,500 in additional federal income tax and filing-related expenses because thefederal government is prohibited by the Defense of Marriage Act from recognizing same-sex marriages. Bosia, 51, has to pay that tax on the value of the health coverage he gets for Obranovich, 45.

Bosia says the difference in tax treatment at the state and federal levels creates headaches for the couples accountant at tax filing time.

Dealing with the different rules, he says, "takes more time and costs more."

According to areport published by two think tanks, the Center for American Progress and the Williams Institute, which conducts research on gender identity and sexual orientation, an employee who buys health insurance for a domestic partner of the same or opposite sex pays $1,069 more a year in federal taxes, on average, than a worker in a heterosexual marriage would pay for the same coverage.

Nine statesand the District of Columbiacurrently permit same-sex marriage, according to the National Conference of State Legislatures.

Last month, the Supreme Court heard oral arguments in two cases that relate to same sex marriage. In addition to the challenge to DOMA, thecourt considered a California-based case challenging whether states can ban same-sex marriages.

The rulings are unlikely to have a direct impact on same-sex couples in domestic partnerships or civil unions, says Tara Borelli, a staff attorney at Lambda Legal, an advocacy organization for lesbian, gay, bisexual and transgender people.

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The Hidden Cost of Health Care for Same-Sex Couples