When Teens Are Stuck in the Middle With No Health Insurance

Annie and Doug Schulte each have health insurance through their jobs. She works for a tiny nonprofit, and he is a truck driver.

But neither of their employers offers coverage for children. As a result, their son, A.J., 16, is uninsured. That's a constant worry for his parents. "You always have this fear he'll get into a car accident,'' says Annie, 36, of Foley, Mo.

The Schultes make too much money for A.J. to qualify for coverage through Medicaid or the state Children's Health Insurance Program (CHIP). And private insurance for their son is too expensive, with insurers setting a high sticker price because of his allergies and asthma.

A.J. is one of more than 7 million U.S. children who have no health insurance. The good news is that number has dropped to its lowest level in 20 years, Census figures show. The decrease comes largely from government programs Medicaid and CHIP picking up more children as private insurance erodes among parents.

Uninsured kids tend to have more health problems. They are 10 times more likely than insured children to have unmet medical needs, such as untreated diabetes, according to the Children's Defense Fund, a Washington, D.C.-based advocacy group.

A recent Johns Hopkins Children's Center study found that uninsured children who are hospitalized were much more likely to die there than those with insurance coverage. Lack of coverage may have led or contributed to more than 16,000 deaths among hospitalized U.S. children from 1988 to 2005, the researchers found.

Annie Schulte, meanwhile, says A.J.'s allergy and asthma symptoms have recently improved. Yet they still pay for all of his medical and dental care out of pocket.

He uses an inhaler when his allergies flare. Those cost up to $60, Annie says. When A.J. needs to visit a doctor, they go to a federally qualified health center, where the charge is $70. She pays out of pocket for dental visits twice a year. And there's a nurse in their family who can be called upon to help with medical care for A.J.

Still, A.J. is an active teen. He plays soccer and now drives a car. His mother worries about him breaking a bone, or worse, getting into an accident. "The biggest fear is something big happening,'' she says, adding that she would gladly give up her insurance policy to cover her child.

Her son's insurance problem has sparked her interest in health care reform. But Tuesday, the chances of Democrats passing their overhaul nose-dived when Republican Scott Brown won the U.S. Senate race in Massachusetts. Brown's victory gives the GOP enough votes to block the plan's passage.

One feature of the Democrats' plan would prohibit insurers from discriminating against people with pre-existing health conditions. Annie Schulte supports such a ban, because her son's health conditions have made a separate policy for him too expensive, she says.

Alison Buist, director of child health for the Children's Defense Fund, says such insurance reforms on pre-existing conditions would help countless families. "There will be millions of children better off,'' says Buist.

The outlook for health reform, though, shifted this week with Brown's victory, and it's unclear whether Congress will pass major insurance changes.

Under the current system, meanwhile, the middle class has trouble finding affordable coverage, Annie Schulte says.

"I'd love for people to understand that individuals who are low income can get health care from the state,'' she says. And those with high income can afford high premiums, she adds. "The folks who are stuck in the middle -- they're the ones who are unable to afford health insurance.''
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