On Bended Knee, With a Very Low Copay

Most of my girlfriends who have received a marriage proposal told me they had a sneaking suspicion it was coming. I, however, was completely blindsided when my boyfriend proposed marriage so that I could receive health care on his plan. I had never considered marrying someone for insurance. Love? Yes. Children? Sure. Health care? Not so much.

The proposal from Brian was all business. It went something like this: "We could sign a prenup, go down to City Hall and get a marriage certificate. It's just a piece of paper."

Talk about unromantic. I knew that people married for many reasons, but when did matrimony become a way to scheme our busted health-care system? I always imagined that marriage encompassed values like commitment, love, and companionship—not $30 copays and in-network doctors. I wasn't sure how serious Brian was, so I asked him to clarify his offer. "Is this something you'd seriously consider?" I asked.

I waited for the punch line or the "just kidding," but neither came.

"Why not? The system is broken," Brian said. "It's one way to get around it."

I knew part of the reason Brian made his offer. All of the news reports of layoffs and rising unemployment had left me worried about what would happen if I were next in line to lose my job, and with it, my health care. Like many of my friends, I had coasted by without insurance at times, but two years ago that option became impossible for me: I was diagnosed with multiple sclerosis. The illness was unexpected, and a rude awakening to the exorbitant medical costs sick people can face.

It isn't cheap to suppress an overactive immune system; the injections I give myself every other day to slow down the progression of my illness can cost thousands of dollars a year, but the prices vary depending on one's insurance. I can't trade down or bargain-shop my way through the MRIs, steroids, doctor visits, and copays. And unless a brilliant scientist has an "aha moment" and comes up with a cure for MS, my life will be a series of costly treatments and doctor appointments

Even with good intentions, Brian still based a major life decision on the idea of gaming our health-care system. And he was not flippant about it, either. We both took marriage very seriously, having been products of marriages with less-than-ideal endings. Brian's parents divorced many years ago. My mother and father had their disagreements but somehow managed to stay together and celebrated their 30th wedding anniversary in August 2000. Then my mother died unexpectedly later that year, dashing any hopes that they would really start to fix some of their problems. Call us naive, but Brian and I only planned on doing the marriage thing once.

I told Brian I'd think about his proposal. Several days later, I couldn't get it off my mind, so one night at happy hour, I ran our conversation by a couple of co-workers. One jumped right in: "Well, it's not like you guys don't love each other. You already live together and have dated for over a year. Marriage is a logical next step." He had a good point. I knew that probably nothing would change about our day-to-day routine if we got married. We'd still go on living in our apartment, drinking wine, and watching Mad Men every Sunday night.

But the other co-worker nearly recoiled in horror. "That sounds like a terrible idea," he said. "There have got to be other options out there. Are you really ready to be legally bound to someone?" He was right, too. I thought back to the way my nerves got the best of me, hands trembling as I co-signed the lease on my apartment with Brian in front of our landlord.

But what were my other options? If I found myself unemployed, I wouldn't have health care. If I got married and was covered by Brian's plan, I would seemingly save money, since it would be expensive to purchase an individual insurance plan out-of-pocket. I might also skirt the preexisting condition issue if we got married, since some individual plans might charge a higher premium. But I suspected it might be cheaper to pay for my own individual plan than to get hitched solely for insurance, only to regret it later and spend oodles of money to get divorced. But my illness has already interfered with so much in my life, why should it intrude as a factor in whether I get married? The answer is that it shouldn't. So when I eventually told Brian that I couldn't go through with his proposal, I think he understood why.

When we first started dating, Brian and I got "engaged" every so often at dinner with the help of a paper napkin. He would rip off a section from his napkin, roll it back and forth enough times until the paper became thin and taut and then tie the napkin firmly around my ring finger: it was a pretend engagement, but a promise nonetheless. I knew the rings weren't permanent, but I wore them until they crumbled to pieces. One dissolved under the water when I washed my face in the bathroom sink; another ripped while I was typing. Even though they were made of paper, I thought of them as indestructible. Each one was a romantic, uncomplicated proposal I could accept without question. Hopefully, when the real engagement ring comes along one day, I'll feel the same way.