You could call my marriage untraditional––at least the way it started.
I was newly 25, and my 30-year-old boyfriend, Ryan Brady, was finishing his morning coffee when I told him I loved him, and I wanted to spend my life with him.
And I wanted him to have my health insurance.
This was last December. There had been no plans, no rings or photographers. I did get down on one knee, but only so I could meet his eye; our two cats took up the neighboring armchair.
Just before my spur-of-the-moment proposal, Ryan had been spreading bills, invoices and tax documents across our New York City apartment living room, calculating how much his health care would cost in the coming year. Ryan is a painter and sculptor and spent much of the past decade working as a studio assistant for a renowned artist. Since the beginning of our relationship, the lion’s share of his income had gone to his monthly health-insurance premiums, weekly specialist appointments and expensive medication for an autoimmune disease. If an emergency had struck, it would have set him back thousands of dollars and taken years to recoup.
After crunching the numbers that morning, Ryan called out his calculations. His premium was going up to nearly $500 a month in 2020. That, plus about $200 for medication and more than $300 in specialist visits, meant he’d be spending more than $1,000 a month on health care.
“I’ll be bleeding money,” he said, passing a hand over his face.
I recognized his dread. I had gone without health insurance while unemployed back in 2017. After paying my way through college with scholarships and numerous jobs, I was elated to graduate without debt. I thought I had won. I had beaten the odds and cleared my path to financial security. Nothing else could fall in my way.
I was wrong. After a bout of strep that fall, my throat remained sore and swollen. A doctor at a Brooklyn clinic told me I had developed an abscess in my throat. I left with antibiotics and a bill for $200. Days later, I woke up unable to breathe. My mother, over the phone, urged me to go to the emergency room. My voice was garbled, barely intelligible as I argued that it wasn’t worth the money. Desperation eventually forced my hand, but I insisted on ordering an Uber to avoid the ambulance fees.
That hospital visit cost me thousands of dollars that I couldn’t afford to pay. I put the debt on a credit card and started paying it off once I landed a job the following year. Within a year, I was in the emergency room again. The bill came, and I started all over again.
It’s no secret that my generation faces rough terrain when it comes to our financial futures. Between burgeoning student debt, rising housing costs and stagnant wages, younger Americans are in worse financial shape than the generations that came before us.
Rising health-care costs put another wrench in the works, making it more likely we will accrue medical debt or sacrifice our savings goals to pay for doctor visits. A Federal Reserve survey found that in 2019, 18% of adults had unpaid debt from their own medical care or from medical care for a family member, and 25% of adults skipped medical care because they were unable to afford the cost.
The growth of health-care costs in recent years has outpaced wage growth, as well as the growth of prices in the general economy. The nonprofit Kaiser Family Foundation found that on average, health spending by families with large-employer health plans has increased two times faster than workers’ wages over the past decade. More costs have been pushed onto employees in the form of deductibles, which can be impossible for some to afford, says Cynthia Cox, a vice president at the foundation.
“For people who live paycheck to paycheck, it’s a huge amount of money to pay up front,” Ms. Cox says. “If they had an emergency, a lot of people don’t have the money.”
Suzy Hobbs Baker was one of those people. She graduated from college in late 2006 and entered the workforce as the 2007-09 recession began. She held several jobs and still struggled to afford the costs that came along with her pre-Affordable Care Act individual plan. Ms. Baker was paying about $150 for her monthly premium and had a vascular disorder that cost roughly $6,000 to treat, even with her insurance. She spent a couple of years paying off the debt and decided not to pursue graduate school.
“I didn’t want to have student-loan debt on top of medical debt,” says Ms. Baker, who is now 36.
She was living in Asheville, N.C., and had been dating her future husband, Ted Baker, for about two years when Mr. Baker got a job offer from BMW that came with great health insurance and would move the couple to Greenville, S.C. After he got the job, Mr. Baker casually popped the question over burgers, and they eloped.
“Ted was like, ‘OK, so we should go to the courthouse this week,’ ” Ms. Baker recalls. “We always knew we would elope.”
Days later, they celebrated with their close family members in a small ceremony at the beach. “It was beautiful, it was perfect,” she says. “I think I spent $100 on my dress.”
After they got married, Mr. Baker’s job provided them both with free medical coverage that included access to doctors, a vision center and physical therapists there on the BMW campus. Their copays were minimal, Ms. Baker says, and their vision and dental premiums cost less than $10 a month.
“It wasn’t getting married for the insurance,” she says. “It was us trying to figure out how to build a life together and how to make good financial choices.”
The couple just celebrated their ninth wedding anniversary. They now live in the Washington, D.C. area and have two children. Looking back, Ms. Baker says she and her husband are proud of their decisions, calling it “a classic millennial love story.”
As for myself, Ryan accepted my proposal and we eloped on Christmas Eve. We got married at a courthouse in Portland, Ore., while on a trip to visit my family. We both wrote some vows, and I wore white, though it was a jumpsuit, not a dress.
Our finances have changed for the better now that we’re married. Ryan’s monthly premium now is about 80% less than he would have paid for his own plan, and many of his specialist visits are completely covered. He has been able to contribute more to his savings, and is considering graduate school. We have more freedom to plan for our future, knowing he won’t fall into debt simply by paying for his health insurance.
Some might think of my proposal as untraditional, but I’m not sure I’d agree. After all, marriage has always been an economic arrangement, as Amy March reminds us in the latest film adaptation of “Little Women.”
It’s impossible to disentangle the institution from its historical roots as a means for men to create alliances and control property and wealth. But nowadays, Americans marry for love, and to form a partnership of two equals. Marriage is a test of that partnership, as two people work as a team to build a fulfilling life for themselves and each other. I couldn’t think of a better way to start off our union, by ensuring that my partner can take care of himself, in sickness and in health.
Ms. Fontana is a reporter for The Wall Street Journal in New York. Email her at [email protected].
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