(Bloomberg) — Carriers participating in PPACA must cover same-sex married couples as families, the government said.

Separately, the government said a program for sick Americans who were denied insurance coverage before this year will be extended another month, through April. Insurers, meanwhile, were told to include more health providers for low- income people in their networks next year.

The Obama administration is seeking to maximize insurance coverage ahead of a March 31 deadline to sign up for private plans under the Patient Protection and Affordable Care Act known as Obamacare. The government has regularly adjusted the law's rules, including a decision last week to allow people with health plans that pre-date Obamacare to extend them through 2016. The decisions on married gay couples and the high-risk patient group are the latest such changes.

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"Insurance companies will not be permitted to discriminate against married same-sex couples when offering coverage," Matthew Heinz, the director of lesbian, gay, bisexual and transgender outreach at HHS, said today in a blog post. "This will further enhance access to health care for all Americans, including those with same-sex spouses."

A married gay couple in Ohio sued the state and federal government on Feb. 18 after they tried to buy a family policy through the federal health insurance exchange and were denied because Ohio doesn't recognize same-sex marriages, according to their complaint. Insurers offering family policies to a person with an opposite-sex spouse must also sell to someone whose spouse is of the same sex, regardless of whether the marriage is recognized by their state government, the Department of Health and Human Services said today.

Enrollment data

About 4.2 million people signed up for new policies in the Affordable Care Act's insurance exchanges through March 1, according to the government. There were about 114,000 married same-sex couples in the U.S. in 2011, according to the University of California at Los Angeles School of Law's Williams Institute, which studies sexual orientation legal issues and public policy.

The Ohio couple, Alfred Cowger Jr. and Anthony Wesley Jr., have been together for 28 years and have a 7-year-old daughter, Bloomberg BNA reported. They were married in New York in 2012.

The couple said they had been insured as a family for the past 15 years. Last year their insurer, WellPoint Inc.'s Anthem brand, notified them their policy would be canceled because it didn't comply with some requirements of the health law, forcing them to seek new coverage.

The administration policy reflects "the common-sense reality that couples who are legally married should be treated as what they are: married," Evan Wolfson, president of Freedom to Marry, an advocacy group for same-sex couples, said in an e- mail from a spokeswoman. "The importance of health coverage for your loved ones doesn't change when you cross a state border, and neither should respect for all married couples."

The decision to extend the program for sick Americans, called the Pre-Existing Conditions Insurance Plan, was posted today on the program's website.

"Time is running out," the administration said on the site. "You need to act to avoid a lapse in coverage."

About 21,000 people remained in the program as of Jan. 31, according to data released today by the U.S. Centers for Medicare and Medicaid.

In another change that will take effect in 2015, insurers will be required to include at least 30 percent of federally funded health clinics, public hospitals and other health services used by low-income people in their local networks. The direction came in the final version of a letter to insurance companies participating in the federal Affordable Care Act enrollment system, healthcare.gov. The change had been proposed last month.

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