Middle class struggles with health insurance

I hate to break the obsession with the runaway bride and Michael Jackson, but the health insurance problem is getting worse. According to a new report from the Robert Wood Johnson Foundation, of the 45 million Americans lacking health insurance, more than 20 million are working.



Today, even being employed is no guarantee of health care.



Conservatives sometimes say this doesn't mean people aren't treated; they can go to an emergency room.



In fact, the report said that between one-third and one-half of the uninsured have not been able to see a doctor in the past year because of cost. We also hear that these are largely healthy folks who choose to forgo insurance. In fact, one in five adults without coverage reports being in poor or fair health, vs. one in nine of the insured.



In Texas 27 percent of employed adults are uninsured. New Mexico, Louisiana and Florida also have large numbers of workers lacking coverage. Arizona has nothing to brag about, with 17 percent uninsured. But the problem goes even deeper.





• Taxpayer-funded AHCCCS, the Arizona Health Care Cost Containment System, covers many workers in this low-wage state. Remember, in Maricopa County alone an astonishing 71 percent of jobs pay below the national mean. In a sense, AHCCCS is a growing public subsidy for employers - including some of the most profitable companies in history - that don't cover employees.





• But AHCCCS eligibility rules can bounce workers in and out of coverage, depending on their wages, with waiting periods in between with no insurance. Arizonans are particularly vulnerable with so many people working in the cyclical trades.





• Small businesses increasingly find it difficult to afford insurance for their employees, sending more workers into public health care or the ranks of the uninsured.





• Sudden illness can ruin uninsured families. A Harvard study shows that about half of personal bankruptcies are a result of medical catastrophes.





• Even as companies have enjoyed record profits and productivity growth in the past few years, more are cutting health benefits.



In Mesa, Sarah and Aaron Arnett and their three children live this frightening reality.



Aaron Arnett works for his father's roofing company, which is too small to afford employee insurance. If he has a good year, the family can't qualify for AHCCCS; yet a good year doesn't pay enough to afford individual insurance.



"It scares me a lot," said Sarah Arnett, 27. "All I know is everyone my age has this problem. We're sitting on the bubble. We're all middle class. I'm not sure what I'm going to do."



For America, doing nothing is increasingly untenable. And relying on the current patchwork won't work, either. It is no longer the finest system in the world, as everything from its high costs to numbers of uninsured attests.



There's a larger context. About the kindest thing one can say is that our leaders are out of touch with the ways changes in the economy are hollowing out the security and promise of middle-class America. Health care is only part of a broad breaking of the social contract.



Yet these changes aren't all natural disasters.



Somebody passed a law that will make it harder to file bankruptcy, and somebody is benefiting. So on down the line, from minimum wage to Medicare. Winners and losers. Insiders and outsiders.



It's enough to make you sick.