The Unexpected Solution: Americans Marrying for Health Insurance as Costs Soar
Published: 2026/01/14 04:27:21
The rising cost of healthcare is forcing some Americans to make remarkable choices. As affordable health insurance becomes increasingly elusive, a decades-old tactic is resurfacing: marrying for health insurance benefits. This isn’t a new phenomenon,but the expiration of key Affordable Care Act (ACA) subsidies at the end of 2025 has brought it back into the spotlight,highlighting the desperation some face to access essential medical care.
Mathew, who asked that his last name not be used, found himself in a uniquely modern predicament.To continue receiving health coverage and manage his autoimmune condition, he married his best friend, Christina. “I find myself in the middle of some sort of rom-com plot,” he admits,describing the situation as “like some wierd twisted plot of ‘Will and grace.’” While unconventional,mathew and Christina’s decision underscores a stark reality: for millions,the promise of affordable healthcare feels increasingly out of reach.
The Looming Healthcare Crisis and the ACA Subsidies
The story of Mathew and Christina is not an isolated incident. It’s a symptom of a larger crisis unfolding as the enhanced premium tax credits – implemented during the pandemic to make ACA marketplace plans more affordable – expired. These subsidies substantially lowered monthly premiums for millions of americans, but their absence has led to ample price increases. According to estimates, millions now face premiums as high as mortgage payments, leaving many with the difficult choice of going uninsured or sacrificing other essential expenses.
The Kaiser Family Foundation (KFF) reported in November 2025 that the average premium for the benchmark ACA plan increased by 30% in many states following the subsidy expiration [1]. This dramatic increase has prompted renewed calls for Congressional action, but as of early 2026, a resolution remains elusive.
A Historical Precedent: Marrying for Benefits
The practise of marrying for health insurance isn’t new. Before the ACA, employer-sponsored insurance was the primary means of coverage for most Americans. This created situations where individuals would marry solely to gain access to a spouse’s health plan, or delay divorce to maintain coverage.
“With the advent of the Affordable Care Act, this question faded to some degree because there were better options for someone who didn’t have access to employer-sponsored coverage to get covered in an affordable way,” explains Erin Fuse Brown, a health law professor at the Brown University School of Public Health [2]. Though, the expiration of the enhanced subsidies is pushing people back towards these unconventional solutions.
Fuse brown emphasizes that while ethically questionable to some, marrying for benefits isn’t illegal. “If you say this person is your partner, it’s not the job of the H.R. department — or the law — to question: how sincere is this personS marriage?” she states. “People get married for a whole bunch of reasons that are non-romantic — they could be economic,they could be practical,they could be childrearing,there could be any number of reasons.”
beyond Marriage: Other Coping Mechanisms
While marriage is one drastic solution, individuals are exploring other ways to cope with rising healthcare costs. These include:
* Forgoing Insurance: A growing number of Americans are choosing to go without health insurance altogether,risking financial ruin in the event of a medical emergency.
* Cost-Sharing Ministries: These faith-based organizations offer an alternative to traditional insurance, but often come with restrictions and may not cover all medical expenses.
* Medical Tourism: Some individuals are traveling to other countries to seek more affordable medical care.
* Crowdfunding: Online platforms are increasingly used to raise money for medical bills.
though, these alternatives frequently enough come with significant drawbacks and are not viable options for everyone.
The Case of Mathew and Christina: A Platonic Partnership
mathew and Christina’s story is unique in its openness and the depth of their long-standing friendship. They’ve been platonic life partners for over two decades, sharing a home and supporting each other through life’s challenges.When faced with the prospect of unaffordable health insurance,they considered their options and ultimately decided to formalize their bond through marriage.
“We both came to the realization — there’s nothing really phony about our marriage other than the fact that we’re not romantic and we were not physical with each other,” Mathew explains. “We share the burdens of day to day life and we have for over 15 years of living together and 25 years of friendship.”
Their situation highlights the complexities of the healthcare system and the lengths people will go to in order to access necessary care. While their arrangement allows Mathew to continue receiving treatment for his autoimmune condition, it also underscores the urgent need for extensive healthcare reform.
Looking Ahead: What’s Next for Healthcare Affordability?
The future of healthcare affordability in the United States remains uncertain.Congress is currently debating potential solutions, including extending the ACA subsidies or implementing other measures to lower costs. However, reaching a consensus will require bipartisan cooperation, which has been challenging in recent years.
Simultaneously occurring, individuals like Mathew and Christina are forced to navigate a broken system and make difficult choices. Their story serves as a powerful reminder that access to healthcare is not a privilege, but a basic human right.
Key Takeaways:
* The expiration of ACA subsidies has led to significant increases in health insurance premiums.
* Marrying for health insurance benefits is a practice that is resurfacing as costs rise.
* millions of Americans are struggling to afford healthcare, forcing them to make difficult choices.
* Comprehensive healthcare reform is urgently needed to ensure that everyone has access to affordable, quality care.
Sources:
[1] https://www.kff.org/health-reform/analysis/aca-marketplace-subsidies-expiration-effects/
[2] https://cahpr.sph.brown.edu/people/erin-fuse-brown
