The rising cost of healthcare in the US has led some Americans to make drastic decisions to manage their expenses. Mathew, a 40-year-old man from Michigan, is one such individual who has taken a significant step to ensure he can afford his medical care. Due to his autoimmune disease, Mathew requires regular medication transfusions, and his healthcare costs were manageable with the Affordable Care Act (ACA) subsidies. However, when the enhanced subsidies expired at the end of 2025, his monthly premium skyrocketed from $181 to over $427, making it unaffordable for him.
In a surprising turn of events, Mathew’s roommate and best friend of 25 years, Christina, suggested they get married so that he could be covered under her employer-sponsored health insurance. Despite initial reservations, Mathew agreed, and they had a small ceremony in September. This decision has allowed Mathew to access affordable healthcare, with his new premium costing $121 per month.
Mathew’s situation is not unique, and many Americans have made similar decisions in the past, particularly before the ACA. Marrying for benefits is not uncommon, and health law professor Erin Fuse Brown notes that people get married for various non-romantic reasons, including economic and practical considerations. While Mathew’s decision may seem unusual, it highlights the desperation and creativity that people are employing to cope with the high cost of healthcare.
The expiration of the enhanced subsidies has left millions of people facing unaffordable monthly premiums, with some opting to forgo insurance or make drastic changes to their lives. Congressional lawmakers are working towards a deal to revive the subsidies, but in the meantime, individuals like Mathew are taking matters into their own hands. Mathew’s story serves as a reminder of the need for affordable healthcare and the importance of finding solutions to the current cost crisis.
Mathew’s new health plan has allowed him to access the medical care he needs, but he is still hoping that Congress will make a deal to restore the subsidies. He believes that not everyone has the option of marrying a friend to get affordable healthcare and that a more comprehensive solution is necessary to address the healthcare cost crisis. As Mathew navigates his new insurance plan, he is scrambling to secure referrals and prior authorizations to continue his medication, highlighting the complexities and challenges of the US healthcare system.