Friends With Benefits

Best buddies become domestic partners for the insurance plan.

By Ona A. Keller, Wellesley College

People marry for a lot of reasons—love, money, a ticking biological clock. But health insurance? For the uninsured, sometimes yes.

My friend Rob has diabetes, which requires reliable, continuous, and expensive care, but he couldn’t afford health insurance as a self-supporting college student in California. Like at least 6.7 percent of college students, he was totally uninsured; many more have insurance that doesn’t meet American College Health Association standards. Then three years ago, one of his best friends offered a solution to his health insurance problem: a domestic partnership. His friend’s job provides excellent health insurance to its employees and their spouses or domestic partners. After a little paperwork, Rob could soon have the reliable health care he so desperately needed. “I’m a survivor,” he says. “I was very actively trying to find a way to get health insurance. My friend had heard about other people doing this; it seemed like a viable option. If there’s one thing to be selfish about, it’s health care.”

Rob and his friend doctored documents to show that they lived together and had a relationship, and Rob has been on her insurance ever since. “The domestic partnership opened up a back door to health insurance for me,” he says. He doesn’t feel guilty that he has essentially fleeced the system. Rob would recommend a domestic partnership to anyone facing a similar situation, but the simple fact remains that no one should have to enter into domestic partnerships or marriages to get the health care they need.

In her book “Generation Debt: Why Now is a Terrible Time to be Young,” Anya Kamenetz lays out the bleak economic prospects for our generation. “Thirty percent of Americans aged 19 to 29 consistently have no health insurance, more than any other age group,” she writes. Half of young people without proper health insurance do not receive needed medical care—not to mention preventive care, the lack of which drives up overall health costs since potential problems are not caught early.

Without treatment, even minor problems can linger for many months. When I told a friend that I was writing about young people without insurance, he exclaimed, “You have to talk to my friend Chris. He has the most disgusting case of ringworm and he can’t get rid of it.” Chris has had ringworm on his arm and leg for about a year but has been without insurance since he turned 18 and was booted off of his parents’ plan. Chris works as a cook, and his employer only offers health insurance to full-time employees. “And of course,” Chris says, “I work 38 hours a week.”

Chris has tried to treat his ringworm more than once. He went to a free clinic and received a one-time prescription for a cream that turned out to be over-the-counter and didn’t work. Next, he impersonated a friend’s brother who had health insurance and was able to get advice over the phone about how to treat his ringworm. But the doctor couldn’t prescribe anything without seeing him. “Obviously I couldn’t go in, because then they would know I wasn’t her brother,” he said. “But it was really helpful to talk to a doctor, and he gave me some good advice.” Lately, Chris has been thinking about going to a low-income clinic, but the clinic is still probably too expensive for Chris’s budget and has a months-long waiting list. Though his ringworm has finally been getting better, a year is a long time to endure such an easily treatable condition. In the meantime, Chris has also had to avoid activities such as skateboarding that might result in an expensive injury.

Young people like Rob and Chris probably have low enough incomes to qualify for state health insurance programs. Unfortunately, many states, such as Minnesota, Tennessee, and Oregon have cut young, unmarried people out of their state health insurance programs. The goal of these cuts was to save money; ironically, young people cost far less to insure than any other age group. In the long term, these cuts may backfire as young people go without the preventive care that could catch costly health problems early.

Luckily, not every state is so backwards. Earlier this spring, Gov. Mitt Romney (R-Mass.) signed a bill that would make Massachusetts the first state in the nation to have almost universal health insurance coverage. Under the law, every person in Massachusetts is required to have health insurance. People can buy private health insurance at group rates, and lower-income people will receive subsidies from the government. The program represents a shift in government priorities. Instead of subsidizing the money-losing emergency rooms—the only place most uninsured people can reliably turn for medical care—the state is stressing prevention and early detection by giving people the means to visit doctors in clinics.

Although other states are starting to toy with some of the components of Massachusetts’s health care plan, it will ultimately take a national program to prevent the uninsured from falling through the cracks. Until that day comes, maybe Chris should start looking for a friend with health insurance who’s willing to say “I do.”

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