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In Sickness and Health (Care): Marrying To Get a ‘Blue Card’

Several days ago I developed a dreadful cough and started feeling feverish. Fearing pneumonia, I rushed home to my boyfriend and said, “Let’s get married!”

I am one of more than 41 million Americans who, according to the U.S. Census Bureau, currently live without health insurance, . Nine months ago I left a career as an analyst on Wall Street to become a full-time freelance writer. For a few months I paid for COBRA, an extension of my former employer’s HMO plan. Then the company I used to work for was sold to an investment bank, and things changed. The new firm’s coverage was different — I could continue to pay for it, but it was nearly 50% more expensive, so I let it lapse.

I spent weeks diligently researching health plans for the self-employed. The Healthy New York plan, sponsored by New York state, only accepted individuals with annual incomes under $22,275 who had been without insurance for at least 12 months. Guardian was too expensive, and the Oxford Liberty plan excluded all of my current doctors, whom I’d been seeing for six years. I searched for a bare-bones policy that only handled emergencies, but found none. All the plans had one thing in common: They only covered married couples.

All the while my boyfriend, Seth, was beside me, dangling his bright-blue Oxford card in my face the way a gray-haired CEO might entice a trophy wife with diamonds. Stressed and perpetually frightened of microbes and falling debris, I finally accepted his offer. I’d heard of people getting married for green cards. Was doing it for a blue card so different?

I am not alone in this crisis. A Robert Wood Johnson Foundation report released earlier this year estimated that 74.7 million Americans under age 65 were uninsured for all or part of 2001 and 2002, and that two-thirds of them were uninsured for at least six months.

“We are extremely concerned about the number of uninsured,” said Diana Aviv, director of the Washington Action Office of United Jewish Communities. The UJC is involved in lobbying and public education efforts geared toward health-care reform and planned cuts to Medicare and Medicaid. “It is not uncommon for a public policy to affect people’s marriage decisions.”

As the unemployment rolls have swelled, the number of independent and contract workers is growing. Health insurance is their No. 1 concern, according to Sara Horowitz, founder and executive director of Working Today, an advocacy group offering benefits to freelancers. “We need a new social safety net that allows for flexibility and mobility, and takes the economy into account. We’ve forgotten the lessons of the 1930s.”

Living without coverage comes at a high price. The Alliance for Health Reform reports that the uninsured are more likely to delay medical care and leave prescriptions unfilled. They have greater risks than the insured of dying from a variety of illnesses.

Kelly, an old colleague, had insurance for her dog but none for herself. I knew a journalist who survived for years with only travel coverage, pretending to the insurance company that she didn’t really live in New York; another who ate exclusively organic in an attempt to stave off illness. Dan, a friend of a friend, drank a pint of vodka and stitched up his own finger after a nasty cut for fear of bankruptcy in the emergency room.

“The day I lost my job, Joe proposed,” said Julia Hess, who lives in New York. “My family is in nursing, so I was terrified of not having insurance, and COBRA was too expensive.” She and her husband, Joe Bonner, had already planned to get married, but the insurance problem made them move up their wedding date; they had a secret City Hall ceremony a week after Julia’s layoff and a public one six months later. They never told their parents.

Sarah Kanchuger and Eric Rice had been living together in a committed relationship for three years when they had a child last October. Their daughter was insured under Eric’s employer-provided plan, but Sarah, who was working only part time, was not. She was ideologically opposed to the institution of marriage, but because private insurance plans were too expensive, she felt that she had no alternative. They were married at the federal courthouse in Baltimore last Halloween.

My own non-married status was an integral part of my identity, one that I was reluctant to give up. Although I was in a long-term relationship that approximated wedlock, I took pride in the fact that it wasn’t official. I had watched in dismay as intelligent women friends dropped their names,


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