One reason for that is that some couples fear losing their government-funded benefits once they tie the knot. It's all uncharted waters for both the state and federal government.
Tim and Tom McElroy have been waiting 15 years to get married, but they have now decided to wait.
"We are afraid we are going to lose some of the income that we've got coming in," says Tim McElroy
Their supplemental security income, or SSI, brings in $300 a month. Without it, they couldn't make ends meet.
This is what they're afraid of: When deciding who is eligible for public programs, the income of both partners is combined.
But SSI is a federal program, and since the federal government does not recognize same sex marriages, the McElroys may be spared. But, it may be different for public programs administered by the state, such as Medi-Cal and the Aids Drugs Assistance Program. That's because California recognizes same-sex marriages and has a domestic partnership law.
"Under California law if you enter into a domestic partnership, your income and property are from thenceforward treated the same way a married couple would be so your income of either of you become community property," says Terese Stewart from the City Attorney's Office.
It's an issue proponents of gay marriages didn't think of.
"Interesting. I don't know. I haven't thought that through. Fantastic discussion. Look forward to understanding it," says San Francisco Mayor Gavin Newsom.
It goes without saying, the issue is complex. So much so that the State Department of Public Health has yet to decided what to do. In this statement they say: "We are in the process of evaluating what changes, if any, will need to be made as a result of the State Supreme Court ruling."
Several health care advocacy organizations are urging the state to decide quickly. Project inform is one of them.
"Because a lot of couples are concerned, they'd like to make their marriage plans before October because of the ballot initiative that will be on the ballot in November," says Anne Donnelly of Project Inform.
That initiative would ban same sex marriages in California.
"It's really hard to be given a right that you fought your whole life to have and suddenly not be able to take advantage of it," Tom McElroy.