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Saying 'I do' -- for a health plan

With medical costs rising, gaining access to benefits is becoming a factor in some couples' decisions to wed.

June 28, 2004|Daniel Costello | Special to The Times

Tamra Crume had little intention of marrying again. She tried it once before, in her early 20s, and thought the whole idea was outdated, oppressive, unnecessary.

But there they were last New Year's Eve, she in her short sleeve, off-the-rack sea-green dress, her partner of a dozen years, Keith, in a gray suit from the closet, driving 45 minutes to a suburban Maryland courthouse to say "I do." Why the sudden change of heart?

"I needed health insurance," says the 38-year-old catering manager, who was so nonchalant about her nuptials she bought a cheap disposable camera for pictures on the way. She took one photo: It came out fuzzy and cropped her at the knees.

Crume had moved from Oregon to Washington, D.C., two years ago and couldn't find work. Her doctor and prescription bills were running several hundred dollars a month. Her boyfriend's generous government insurance benefits looked more and more attractive.

For The Record
Los Angeles Times Friday July 02, 2004 Home Edition Main News Part A Page 2 National Desk 1 inches; 35 words Type of Material: Correction
Uninsured Americans -- An article in Monday's Health section about couples who marry to obtain health benefits said an estimated 44% of Americans lack health insurance. The portion of Americans without such coverage is 15%.
For The Record
Los Angeles Times Monday July 05, 2004 Home Edition Health Part F Page 6 Features Desk 1 inches; 36 words Type of Material: Correction
Uninsured Americans -- An article in last Monday's Health section about couples who marry to obtain health benefits said an estimated 44% of Americans lack health insurance. The portion of Americans without such coverage is 15%.

"I figured it made more sense to pay the money to get married rather than keep paying the bills," she says.

Love and marriage may go together like a horse and carriage, but for some couples a dance down the aisle these days may have more to do with dollars and cents. Although no one keeps statistics on how many couples marry each year to gain access to health benefits, there are signs the arrangements are growing among people who can't afford medical coverage and those struggling under the burden of rising insurance premiums.

Advertisements on the New York City subway this month by a group promoting affordable health insurance read, "Get Married for Love, Not Health Insurance." Internet chat rooms are filled with people communing about the benefits of marrying for health benefits and trading tips on how to do it right. (Fees for marriage licenses and other costs can vary considerably depending on where people get married.) Some patient advocacy groups, including the American Diabetes Assn. and the American Cancer Society, say a small but growing number of seriously ill people are using marriage as a last resort to deal with potentially crippling medical bills.

The recent legalization of gay marriage in Massachusetts also could lead more couples to marry for medical benefits. Last month, town managers in Springfield, Mass., stopped offering domestic partner benefits to unmarried couples and gave them 90 days to marry if they want to keep their insurance benefits. Other Massachusetts employers, including Boston College and Beth Israel Deaconess Medical Center in Boston, are ending partner benefits by the end of the year.

Unlike the 1990 movie "Green Card," in which two strangers marry so one can stay in the country and then later fall in love, most couples who marry for insurance reasons have been together for years. Many explicitly didn't want to get married -- or at least had not planned to wed so soon. Occasionally, friends marry friends or a single parent with a sick child and mounting medical bills finds someone to marry and agrees to pay the extra insurance costs.

Experts say those marrying for health insurance should be careful. Although the long-maligned "marriage tax" has been reduced in recent years, financial experts say some couples may still pay significantly more in income tax once they're married. What, too, if love ever wilts? Divorce lawyers recommend couples marrying explicitly for insurance reasons have a prenuptial agreement in case the relationship sours down the road.

Drew Tipson and his wife, Emma Brooks, had been in a relationship for years but didn't consider marriage until last year, when Tipson began having intense pain in his neck and head, which doctors still haven't explained. Tipson, 26, is a freelance worker for a Manhattan law firm and doesn't qualify for health insurance. Brooks, a 25-year-old medical student, has health insurance, but her plan doesn't cover unmarried domestic partners unless they are gay.

So, just weeks after telling their parents they probably would never legally marry, the two families found themselves together at a New York City courthouse during Tipson's lunch break. The 10-minute civil ceremony wasn't the wedding his parents might have imagined.

"The most tragically bored woman in history read out the ceremony script in a nondescript room that could have been a police interrogation chamber," he says. Afterward, "the two of us left and headed down different subways to go back to work. I think my parents were left standing there thinking, 'What in the heck just happened?' "

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