Edwin Blesch, 72, and his partner Tim Smulian, 66, have been together for 14 years and married for more than five. The state of New York recognizes them as a married couple. But when it comes to immigration status, the federal government does not. Unlike heterosexual, married couples who can apply for green cards to stay together in the United States, Smulian, who is from South Africa, has had mostly temporary visas, which only allow him to spend six months of the year in Long Island, N.Y., where his partner lives. The other six months Blesch and Smulian have traveled elsewhere at a high cost to both their health and their bank accounts. Blesch, who is HIV positive, has been spending much of his time in Canada to stay with Smulian. But because Blesch does not get Medicare coverage abroad, he has had to return to the U.S. multiple times to confront health problems alone. "We do it because we are married and together, and we intend on staying together forever," Blesch says. "But, it's been a struggle." "It's extremely disruptive," Smulian adds.