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Marrying, and Voting, for Health Care

by Nicky Grist, executive director, Alternatives to Marriage Project 

For our grandparents, a "shotgun wedding" meant you had fooled around and got (or got someone) pregnant.  Now, it means you care about someone enough to put him or her on your health insurance. 

Seven percent of registered voters say someone in their household decided to get married mainly to have access to health care benefits, according to a Kaiser Family Foundation poll released last week.  There is some quibbling over the math, but don't let it distract you.  The key point is that marriage is the on / off switch for access to health care in America. 

That makes the United States unique: health care does not depend on marital or relationship status in other developed countries.  It is time for American society to recognize that all singles, partners and families have health care needs and responsibilities.  No one should have to get married, civil unioned or domestic partnered in order to have access to health care.

I hope that the KFF poll results will get policy makers to take this seriously.  If they heard the stories we hear every day, they would leap into action.  A survey at our website www.unmarried.org asks "Have you experienced discrimination on the basis of your marital status?" Of more than 2000 detailed responses, 20% cite discrimination in access to health care. In addition, over 850 people have submitted detailed tales of woe concerning health care through the survey and personal emails.

Yes, people get married in order to get health insurance, and many of them are upset that they were forced to rush into things or compromise their values.  True, some employers extend benefits to domestic partners; often their employees (many of whom who are boycotting marriage "until everyone can marry") are hurt and confused to discover that only same-sex partners are covered.  Unhappily married couples don't divorce so that both spouses can keep job-based health benefits.  At the same time, there are loving couples who don't marry because they would lose their disability insurance or military survivors' benefits. 

Marriage is also the on / off switch for health care resources beyond insurance: the ability to take time off to care for your loved one; the ability to make medical decisions for someone who is is incapacitated. 

Getting married only opens health care doors if you're a couple.  Yet singles shoulder many extended family care responsibilities.  They can't marry their unemployed siblings or not-elderly-enough-for-Medicare parents to put them on the company plan.  No wonder singles look at the pricey family benefits of their married co-workers and feel they're getting un-equal pay for equal work.

Health care is the number one domestic priority for voters.  And for unmarried voters it is an especially important issue.  Political researchers found that over 14% of unmarried voters were unable to pay for needed health care in the past year (compared to less than five percent of married voters).  They also found that unmarried voters strongly support fundamental health care reform to provide universal coverage that can never be taken away.

Addressing the health care concerns of unmarried people is a key to winning elections.  Over 89 million unmarried Americans are eligible to vote; for each new married voter there are almost 2.5 new unmarried voters.  Singles are a bigger demographic than seniors, people of color or union members; moreover, marital status is a better predictor of how someone votes than other demographic features.  With increasing registration and turnout numbers, unmarried voters are the ones to woo for every candidate, in every race.

Given all these facts, why are we still waiting to hear a candidate pledge to separate health care from marital and relationship status?  We must unplug that marriage switch if we are ever to develop a truly universal health care system.

Providing equal access to high-quality, affordable health care would help reduce the disparities in income and wealth between married and unmarried people. It might even result in better marriages: people should marry only if and when they really want to, rather marrying for health insurance.

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