If patients and doctors need permission from the Political State to do their business, shouldn't sexual partners also have to get State approval?

Other than sexual relations, there is not much more personal than the relationship between patient and doctor. But Obamacare establishes that the doctor/patient relationship is not private, but that it engages the interest of the Political State, since the State uses tax money to pay for parts of the program
So how long until the glorious State is allowed to judge what elements of a sexual relationship conform to State standards. Whatever that may be, depending on the election cycle.
Within a range of 5 years.