Several years ago Ernest Walston was involved in a severe accident that left him disabled with chronic back pain. Through Ernest’s former employer he and his wife Vivian received health insurance benefits, but after almost three years disabled and living off a pension those benefits are about to change.

Vivian was allowed to continue coverage through Ernest’s former employer for 36 months under the federal COBRA program. That coverage expires early next year, however, and their research into health insurance thus far has found few options.

Vivian is disabled herself from her days with the post office and she stays home to take care of her husband. “He has bad days sometimes,” she told us, and on those bad days it’s important that someone be there for him. Ernest has nearly constant pain as a result of his back injury and takes pain killers to help him live a normal life. But his insurance company restricts the amount of prescription pain medicine it will cover, leaving him with no medicine every three days. These are the bad days Vivian described.

Despite his pain, Ernest is more worried about getting coverage for his wife. After spending hours filling out numerous applications they discovered that the only option available to them is the Oregon high risk insurance pool.

A few weeks ago we interviewed Matt in Lincoln, NE who calls his own high risk pool insurance merely “catastrophic coverage.” But for Vivian, the problem goes deeper. She and Ernest can barely afford the premiums of about $500 per month. But with both of them disabled and living on pensions, the out-of-pocket costs will just be too much. The insurance comes with a very high deductible of $5,000, meaning virtually any routine medical care she might need will not be covered.

So now Vivian is considering returning to work, but with limitations of her own she will have difficulty finding a job that provides insurance and an income that matches the pension she will lose.

We interviewed Vivian and Ernest in Portland, Oregon together, because really that’s the way they live their lives. “We’re a team,” Vivian told us. They described their relationship in terms of each other’s strengths and weaknesses and as we listened it became clear they meant what they said. She takes care of him as he lives life disabled, and he takes care of her, exhausting all options to find his wife health insurance.

Ernest and Vivian are all too typical of the people we have met along the way on the Cover America Tour, people who because of no fault of their own are finding it impossible to get decent and affordable health care. And we learned yet again that even though high risk pool insurance is sometimes the only option available, it’s almost never a good one.

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1 Posted by Jackie Justice at 08/19/08 12:07 AM

Thanks for visiting with me in St. George today! When I got home my husband had similar stories to this one from fellow employees. Although his insurance company has a $2000 per insured person deductable, a few of the other workers find necessary to save money all year to pay for it at the first of the next year so they can get the care that they need outside routine doctor visits and prescriptions for their spouse and/or children. One worker's wife got a job just for the insurance it had for the kids because they couldn't afford the deductible on his. For us and them, preventitive health care is not an option. Due to construction in housing at a standstill all employees are under 40 hours a week which puts even more stress on us to cover the $2000 deductible. Thank goodness for cobra options but it still puts a strain on an already strained budget.

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