There's always some form of "choice". For instance, the two gay men could attempt to immigrate to country where they could marry. But at what price?
I don't know Ari's situation, but I can guess because I'm living through something similar. When he states that "we can't marry", I'm guessing he came to that conclusion after looking at the full bill.
When you go from being a person's partner to being a dependent, when you lose all sources of income (don't count on that social safety net), when you can do few to no fun things together anymore, it doesn't feel like much of a choice anymore.
It takes a special type of person to marry into that. And if you do marry, you need to live with the guilt of imprisoning them forever too. This kind of thing is not a spectator sport. Everyone participates, and suffers. That's "choice".