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Diabetes Forecast

The Healthy Living Magazine

At Economic Ground Zero

A Michigan Family Faces Job Loss and Health Worries

By Katie Bunker ,

Kenny Bott, 54, a third-generation Detroit autoworker, is but one casualty of Michigan's high unemployment, which hit 14.1 percent in May, the nation's highest. Bott was laid off last December by Chrysler, which filed for bankruptcy reorganization this spring. Like many of the state's unemployed, he had depended on employer-sponsored health insurance, particularly because his 11-year-old daughter, Taylor, was diagnosed with type 1 diabetes 2 1/2 years ago.

Bott, who worked in quality control at a Dodge Viper plant, had been with Chrysler for 32 years, enduring a bumpy ride that included a government bailout back in 1979. In 2008, his plant was forced to cut back on production and eventually closed when a supplier went out of business. That put the Viper plant's employees on layoff temporarily until a new supplier could be found. The layoff presented a new challenge, says his wife, Donna, who has been a full-time mom for 11 years. "The first thing that popped in my head is that I need my health insurance for my daughter," she recalls. "She needs the care; she needs the supplies."

Fortunately for the Botts, Michigan's Children's Special Health Care Services program is picking up most of the costs that aren't covered under Chrysler's medical insurance—which, for now, the family is still receiving under the United Auto Workers contract. This May, the Botts got one more reason to care about health insurance: Kenny had a heart attack. While undergoing rehabilitation, he was also weighing the company's offer of early retirement, extended to current employees and employees on layoff, which he later accepted. The Botts knew that following Chrysler's Chapter 11 bankruptcy filing, nothing would be guaranteed, including contractual obligations like health insurance. Their dental and vision benefits expired last month. "The unknown is very nerve-wracking," Donna Bott says.

The Southeast Michigan–Northwest Ohio office of the American Diabetes Association gets many calls from people like the Botts who are struggling to pay for diabetes care and supplies, says Kelli Dobner, an ADA associate director. Recently, she says, "a woman called; her husband had had his foot amputated because of diabetes. She needed Lantus [insulin]." Dobner put the couple in touch with a representative of Sanofi-Aventis, which makes Lantus. "They're getting assistance through the company's program now."

Nearly 6 in 10 Americans have delayed or skipped health care in the past year because of cost, according to a Kaiser Family Foundation poll this spring. And a study showed that medical bills caused 62 percent of bankruptices in 2007. People with diabetes spend about 2.3 times as much on medical expenses as people who don't have diabetes, according to the Centers for Disease Control and Prevention. For many, the biggest obstacle to maintaining their health is insurance coverage. At Chrysler, "some folks who aren't lucky enough to have the seniority I do were offered an extended period [of health insurance]," Kenny Bott says, "but then they have to purchase their own COBRA."

COBRA, or the 1986 Consolidated Omnibus Budget Reconciliation Act, gives some former employees and family members the right to continue receiving health insurance benefits temporarily at a former employer's group rate. The insured person generally must pay the full policy premium, including the part once paid by the employer. The federal government is temporarily helping cover the cost of COBRA for some people as part of the $787 billion stimulus package enacted in February. Many workers laid off between September 2008 and the end of 2009 may receive a government subsidy of 65 percent of COBRA premiums for nine months. The stimulus package also earmarked $87 billion for state Medicaid programs. Low-income families can apply for Medicaid or other state assistance, and children may be eligible for coverage under the State Children's Health Insurance Program (SCHIP). Pharmaceutical companies have prescription assistance plans that can provide help, too.

For people with diabetes who don't qualify for government aid, finding a private health insurance provider after COBRA expires or in lieu of COBRA can be difficult to impossible. In many cases, private insurers can deny coverage to people with diabetes, citing the disease as a "preexisting condition." That's why some states offer high-risk pools or insurers of last resort that must cover people with diabetes and other chronic diseases. A few states require insurers to extend coverage on a "guaranteed issue" basis to anyone who wants it. Your state insurance commissioner's office should be able to explain your options. You can also request an information packet from the American Diabetes Association's National Call Center at 1-800-DIABETES (1-800-342-2383).

Getting assistance is even more crucial when you consider a family's costs outside of medical care. For instance, Donna Bott says she budgets for more expensive, healthier foods to manage her daughter's diabetes and to buy gear and pay fees for Taylor and her 14-year-old sister, Shelby, to participate in out-of-school activities—and, in Taylor's case, to attend diabetes camp. Taylor first attended ADA Diabetes Camp Midicha in Fenton, Mich., two years ago, and her father says it's been an important part of her diabetes education and helped her become more independent. This summer, Taylor is able to attend again through the help of an ADA grant.

Now that Kenny Bott has recovered from his heart attack, the family is doing better. But like many Americans today, their worries aren't over. Bott feels for his coworkers and for other people struggling through unemployment. "I think we all have the same feeling of helplessness in a way," he says. Much as when Taylor was diagnosed with diabetes, the Botts have found strength in their family. Bott remembers how his daughter tried to ease his anxiety then by telling him, "Dad, I'm glad it happened to me, because a younger kid might not be able to handle it so well." It's with that kind of spirit that the Botts expect to face up to their latest challenge and win.

 
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