There's been a similarly large fuss over gay marriage in the UK, where 1) the NHS provides healthcare to everyone and 2) existing civil partnership legislation gave gay couples all the benefits of straight couples. So I don't think that practical issue is very important.
(Also, there are many far easier ways of getting health insurance than by upsetting arguably the most important institution in the history of the world!)
Your observation on this subject disagrees with mine. I'd say there was significantly less fuss about gay marriage in the UK. I suggest this is selection effect on one or both of our parts.
There's a lot of background mess in our mental pictures of the world. We try and be accurate on important issues, but a whole lot of the less important stuff we pick up from the media, the movies, and random impressions. And once these impressions are in our mental pictures, they just don't go away - until we find a fact that causes us to say "huh", and reassess.
Here are three facts that have caused that "huh" in me, recently, and completely rearranged minor parts of my mental map. I'm sharing them here, because that experience is a valuable one.