When he stops to think about it, Mathew says, his situation feels kind of ridiculous. “I find myself in the middle of some sort of rom-com plot,” he says. “For me to be able to see my doctor to tend to my autoimmune disease, I had to marry my best friend — it’s like some weird twisted plot of Will and Grace.” Mathew asked NPR not to use his full name because he fears repercussions from his health insurance company if it finds out he got married to obtain coverage. He is not the first American to marry for affordable health insurance, and he won’t be the last. Especially before the Affordable Care Act, marriages, delayed divorces and job decisions were often tied to private health insurance, since it usually required you or a spouse to have a job with benefits. But his decision was forced by the cost crisis facing many of the roughly 24 million people who get their health care via Affordable Care Act marketplaces. Enhanced subsidies that made plans affordable for many people expired at the end of 2025 and Congress failed to extend them before the 2026 plan year. Millions of people face untenable monthly premium prices — as much as the cost of a mortgage for some families. Congressional lawmakers are back at the table working toward a deal that could revive the enhanced subsidies. In the meantime, some have decided to forgo insurance or make drastic changes to their lives to stay insured, like Mathew. “I couldn’t afford to…Read more