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It's pretty common still in multiple countries and in some migrant subcultures living in other countries. The consequences over multiple generations are not pretty.
An article with examples: https://www.dw.com/en/pakistan-cousin-marriages-create-high-risk-of-genetic-disorders/a-60687452
Imo it's still a bad idea to allow it. Even between first cousins of a family without a history of inbreeding, doubling the chance of genetic disorders is not nothing. Scale it up to many people doing it and it becomes a heavy burden on healthcare systems. And in countries with socialized healthcare, it's not really fair that everyone has to contribute more to healthcare because some people want to defy genetics. Imo again.
OK. You're talking about a culture that specifically encourages incest over many generations. Yes, that's problematic.
My point is that the social stigma of 1st cousins marrying far exceeds its actual danger in a more isolated case by case basis. Which is really what we're talking about here.
Also, your argument about Healthcare reeks of eugenics. Should someone with a known family history of <insert genetic disease> be allowed to reproduce? Or reproduce with someone else with similar genetic risks?
To put it another way, should my insurance fees / taxes subsidize your high risk of colon cancer?
Yeah, it sounds like an awful stance, doesn't it?
Your children are the victims and should not be punished because you wanted to fuck your cousin, it's you that should be paying extra taxes to offset the cost to society of your choices.