Twenty-one dollars.
If not for the federal stimulus package, 53-year-old Jean Erickson of Montgomery would have had $21 a month to live on. That's the $638 she has gotten since getting laid off in August, minus the $617 it would have cost to continue her health insurance through COBRA.
(Heather Eidson/Staff Photographer)
PHOTO GALLERY
• Health care examined
• About this series
• Factbox: The underinsured
• Do-it-yourself medicine
• Photos: Health care examined
As the health care debate rages in Washington, we asked for your thoughts about this controversial issue. The response was overwhelming. Hundreds of you wrote, e-mailed or went online to share your feelings. This series addresses the issues you’re most passionate about.
• Sunday: When illness strikes
Even those with insurance aren’t protected from financial and emotional disaster.
• Monday: Don’t take my money
Many taxpayers don’t trust the government to fix the problem; nor do they want to bear the burden of those uninsured.
• Tuesday: Speaking of uninsured
Those who can’t afford health insurance want more options than disability or welfare.
• Wednesday: Fire the lawyers
Some are convinced tort reform could go far in fixing our health care woes.
• Thursday: Your suggestions
So how do you really feel? We look at more of your concerns.
• 25 million adults were underinsured in 2007, a 60 percent increase from 16 million underinsured in 2003
• You are underinsured if you spend more than 10 percent of your income on out-of-pocket medical expenses
• The amount is 5 percent for low-income families
Women-specific pre-existing conditions
A few years ago, Aurora resident Terri Jacobsen left a career in nursing and health information systems to open her own in-home health-care business, Comfort Keepers of Elgin.
As Jacobsen and her husband began to apply for business health insurance, however, they were in for a nasty surprise.
"The bill was $1,500 month as a small business owner," Jacobsen said. "I had a pre-existing condition. Can you guess? Menopause!"
The National Women's Law Center reports 7 in 10 American women are uninsured or underinsured, especially African American, Hispanic and Native American women.
Often women-specific treatments and procedures are not covered, including mammograms, obstetric care and cervical exams.
Instead, she opted to go uninsured for two months.
"I'm one heart attack away from bankruptcy," Erickson joked just days before her stimulus COBRA kicked in.
Even with the 65 percent discount from the federal government, Erickson will be putting more than one-third of her income into insurance.
"I'm not the hardship case with the four kids and the mortgage, but it's every bit as stressful because I'm alone," she said.
Erickson, who has worked since she was 16, is not alone in her struggle with rising premiums and out-of-pocket health care costs. An estimated 25 million adults were underinsured in 2007, according to a study by the New York-based Commonwealth Fund. The number jumped 60 percent from 16 million in 2003.
The group defines people as underinsured if they spent 10 percent or more of their income (or 5 percent if they were low-income) on out-of-pocket medical expenses, or if they had deductibles that equaled 5 percent or more of their income.
Even with the stimulus COBRA, Erickson will be putting 34 percent of her income into insurance.
The underinsured wind up going without needed care, they don't see a doctor when they're sick and they forgo filling prescriptions, according to the study's authors. Erickson went uninsured for two months while waiting to see if she qualified for the stimulus COBRA discount.
Erickson is among those who want to see a "public option" come out of the current health care shouting match infesting Washington. But she's worried that even if a bill passes, it might be too watered-down to make any difference to her bottom line.
"They throw that around, but until you find the details about it — if (the monthly cost) is still $600, I can't afford it," Erickson said.
Stuck in the middle
Twelve years.
At 53, Erickson will have to wait 12 years to get Medicare insurance.
"I am frightened," Erickson said. "Frightened that I will not make it to 65 for Medicare and afraid that Medicare will not be there when I am 65."
She has a pension, but if she claims it at 55 — two years from now — it would only be worth $480 a month.
When Erickson was laid off from Provena Mercy Medical Center in August, she joined a growing group — the middle-aged unemployed. These are people who lost their health care when they were laid off, aren't getting passed over for jobs in favor of younger workers and aren't old enough for Medicare.
The U.S. Bureau of Labor Statistics reported more than 803,000 people age 55 to 65 were unemployed and looking for work last year. That's 121,000 more people than were in the group in 2004 and more than double the number from 1999.
But Erickson knows her economic situation is not as dire as others.
When her mother died in April, Erickson inherited the house outright — no mortgage and the property taxes were paid through the end of the year. Also, it was a cool summer, cutting air-conditioning costs. She has some savings. She has an IRA.
"I'm lucky I have a cushion," she said, sighing and adding that she would trade it all to have her mother back.
Of the 97 Aurora-area responses to a recent Beacon-News health care survey, 22 people said they did not have adequate health coverage. The reasons varied — everything from a complete lack of insurance to four-digit monthly premiums.
"Adequate ... an interesting term," wrote one Sugar Grove man. "I have family coverage through my employer and pay over $4,000 in premiums, plus deductibles and co-payments. Very limited coverage for vision, dental. Yes, I suppose this is 'adequate.'"
Erickson's cushion can't last. Eventually, the weather will change, her savings will dry up, her unemployment will run out, her taxes will need to be paid and her COBRA rate will go up to $649. So instead of barely eking by with $21 a month, Erickson will be an extra $11 in the hole each month — and that's if she still has her unemployment.
She has tried to find lower rates, but her age and weight (she is more than 200 pounds, but not obese) have caused insurance companies to turn her down or only accept her at rates she can't pay.
Erickson jokes that her only health problem will be if dealing with insurance companies gives her high blood pressure.
Well, she's sort of joking.
"I fear that the decisions of insurance companies will be the cause of my death because I will make 'financial survival' decisions about obtaining medical treatment and thus denying myself of needed health care," Erickson said.
Underinsured rising
Eighteen percent.
In 2007, 18 percent of adults age 50 to 64 were underinsured. This was a leap from the 11 percent uninsured just four years earlier, Commonwealth Fund Vice President Sara Collins testified in mid-October before a House subcommittee.
As more and more middle-class wage earners are becoming underinsured, the most rapid growth occurred among adults in households earning between $40,000 and $60,000 annually, Collins testified.
Urging Congress to act on health care reform, Collins spoke in favor of HR 3200, a health care reform bill that includes a public option. That bill would go a long way toward reforming the individual and small-group insurance markets that feature high premiums and high administrative costs. The plan would ensure coverage for people regardless of age, health or pre-existing conditions, she said.
Cherilyn Murer, president and CEO of the Joliet-based Murer Group, a health care consulting company, said in addition to passing health care reform, Congress needs to get at the root of the problem. The amount of money it costs to provide some health care services is out of whack with what is charged.
"We have to have greater transparency as to what things really cost and what people are being charged," Murer said.
Also, insurance companies shouldn't be allowed to play a "gotcha" game when they deny claims based on technicalities.
"People are frightened," Murer said of the need for comprehensive reform. "No one should go bankrupt because of medical bills in a country as wealthy as the United States — that's an absolute."
Kevin and Michelle Oliver ran into problems when it took two years for their small son to be diagnosed with epilepsy. Even though Kevin has insurance through his job, the medical bills have consumed them and thrown their lives into financial chaos.
They moved out of their Plainfield house in March and put it up for sale. Offers have come in, but all have expired while the couple waits for the bank to process the paperwork, said Michele, who now lives with her family in an apartment in Naperville.
The couple missed two car payments, and Kevin's car was repossessed. The lender, looking to collect the remaining due, along with fees and penalties that more than doubled the balance, froze their checking account.
Said Michelle, "We are trying to make ends meet like a lot of Americans today, but are really struggling."