This is part of the America's Future series airing on FOX News Channel, looking at the challenges facing the country in the 21st century.

NEW YORK — Same-sex couples may soon get full health-care coverage for their spouses following a successful court challenges and a directive from the governor.

When Pat Martinez and Lisa Golden joined hands at their marriage ceremony in Canada four years ago, they vowed to care for one another in sickness and in health. But those words carried even more weight when Golden lost some of her health insurance and Martinez's employer, a community college, refused spousal coverage.

Earlier this year, the New York Supreme Court ruled their marriage is valid in New York, so Golden is now eligible to be covered as a spouse under Martinez's health care plan.

"All I'm asking for is what's fair, and if a heterosexual couple gets the benefit then I think I should have it too," Martinez said.

The ruling prompted Gov. David Paterson to issue a controversial memo requiring all state agencies to revise their policies to cover married gay and lesbian couples, a trend that may be on the rise.

"Health care benefits are of paramount importance to all Americans, and I think health care reform issue is one that will play out in many, many ways over the next several months and years," said Donna Lieberman, executive director of the New York Civil Liberties Union.

In light of the Martinez ruling, another lesbian couple filed suit against BlueCross BlueShield of Western New York. Although it already provided domestic partner benefits, it is now amending its policy to include same-sex spousal coverage.

The new policy, which offers same-sex couples the kind of tax-free benefits not available to domestic partners, will go into effect Aug. 1, according to a company spokeswoman.

"It is spouse coverage," said Karen Merkel-Liberatore, senior director of Public Relations and Communications for BlueCross BlueShield Western New York. "And it doesn't matter if it's same-sex spouse, heterosexual spouse — it doesn't matter."

Opponents believe the New York Civil Liberties Union and others are using the health care fight as just another stepping stone to legalized gay marriage.

"It's evolved from [health care] to more of a demand for recognition," said Brian Raum, senior legal council for the Alliance Defense Fund, a conservative group opposed to gay marriage. "In other words, [for] state endorsement, support, encouragement for same-sex couples to marry."

He called the benefits issue "a red herring."

"It's evolved from [health care] to more of a demand for recognition … [for] state endorsement, support, encouragement for same-sex couples to marry," Raum said.

But Martinez's and Golden's battle for equality is not yet over. An appeals court could still take up the case.

In the meantime, Lisa is getting only domestic partner benefits, not spousal benefits.

"People don't realize that we as a same-sex couple that receives domestic partner benefits gets taxed on those benefits," Golden said. "Whereas if it's spousal benefits, like any other married couple out there, they are not taxed on those benefits."

What's clear is that the Martinez ruling has paved the way for other same-sex couples to ask their employers for spousal benefits.

"As it stands right now, our ruling is the law of the land. I think you're going to see that it's going to be like the domino theory," said Martinez.

As Martinez waits to see the effects of her court case, the question remains whether gay couples will get the same type of health benefits in other states, most of which have stronger laws against the recognition of same-sex marriage.

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