MICHELE NORRIS, host:

The shift in focus from health care to job creation is little comfort to the many Americans who have jobs but no health insurance. As part of our series Are You Covered, NPRs Debbie Elliott checks back in with a New Orleans contractor who wants insurance, but insurers dont want him.

DEBBIE ELLIOTT: Winter, what there is of it in New Orleans, is the slow season for Fernando Arriolas construction firm. So, late last year, he took care of a nagging medical problem.

Mr. FERNANDO ARRIOLA (Contractor): I had a minor surgery, you know, it wasnt anything big - just had a growth removed. So I went to Guatemala. And it cost me a grand total of $80, including the doctor visit. I was able to save some money. I couldnt even pay for the doctor visit over here.

ELLIOTT: Arriola is a naturalized citizen who has called New Orleans home for 40 years. But his regular doctor these days is in his native Guatemala. So when he goes to visit family, he gets care and stocks up on his blood pressure medicine. The 58-year-old self-employed businessman gave up his health coverage after Hurricane Katrina to save money when times were tough. When he tried to reinstate the policy, he was denied. Arriola had hoped Congress would allow people like him to pay for early Medicare coverage.

Mr. ARRIOLA: See, Im willing to pay for what Im getting, you know, thats not the point. Its just that I cannot even get it.

ELLIOTT: Hes frustrated that politicians cant seem to agree on a fix.

Mr. ARRIOLA: Its a mess. It is a mess. I dont know that they can do anything.

ELLIOTT: For his part, Arriola has been trying to do something locally for people like him by serving on the board of directors of a fledgling health clinic for uninsured workers.

(Soundbite of construction)

ELLIOTT: At the First Grace United Methodist Church in the Mid-City neighborhood, a construction crew is transforming Sunday school classrooms into exam rooms. Its the new home of the New Orleans Faith Health Alliance.

(Soundbite of exam room)

ELLIOTT: The full clinic wont be ready until late spring. So for now a small, windowless choir room serves as a makeshift exam room.

Ms. GWEN GEORGE (Nurse Practitioner): 144 over 86.

ELLIOTT: Nurse practitioner Gwen George is with a new patient.

Ms. GEORGE: Thats a little bit high, but its not real high.

Mr. LEE HARDY (Producer, Radio Station): Elevated.

Ms. GEORGE: Right. Do you have - have you ever had any blood pressure problems?

Mr. HARDY: I was diagnosed elevated, yeah.

Ms. GEORGE: With high blood pressure? How long was that?

Mr. HARDY: Pre-Katrina.

Ms. GEORGE: Okay. About five years, then.

Mr. HARDY: Yeah.

Ms. GEORGE: Okay.

ELLIOTT: Her patient is Lee Hardy, a morning show producer for a local AM radio station. Hardy had hoped Congress would create a public health plan.

Mr. HARDY: People who think that its for other people out there that dont want to work and people who are just lazy bums and so on and so forth. But that is not the case. I mean, I stand before you as living proof that it's not the case. I mean, I work hard.

ELLIOTT: How long have you been without health insurance?

Mr. HARDY: Well, let's see. Katrina came in 2005, and the job that I had, that I did have health insurance with was gone. So, you can mark it right back to August 29th, 2005.

ELLIOTT: And its been that long since hes seen a doctor, even though his previous job was as a marketing director for a home health care agency. Nurse Gwen George says Hardy is typical of the patients she sees at this clinic. Most have chronic health problems like high blood pressure or diabetes and have gone for years without care. Katrina devastated the citys health care system, including Charity Hospital. Even today, she says, there are few treatment options.

Ms. GEORGE: Unless they go to the university, which is going to be free care, but its hours and hours to wait. And when you have a job, you really cant wait 10, 12 hours to be seen because youll no longer have your job.

ELLIOTT: Since November, the New Orleans Faith Health Alliance has been seeing patients three half-days a week, addressing a mere fraction of the need in this city, where so many work in industries that dont offer health coverage - like construction and hospitality. Clinic director Luanne Francis says there are about 80,000 uninsured workers in the New Orleans metro area.

Ms. LUANNE FRANCIS (Clinic Director, New Orleans Faith Health Alliance): We are specifically focused on serving these people because we think these people are the ones that are falling through the cracks and who go, you know, for a long period of time without seeing a provider.

ELLIOTT: But its not a free ride. Patients must join or become members by paying a fee based on their income and pay for each visit.

Mr. HARDY: Thank you all.

Ms. GEORGE: Okay, thank you, Lee. See you later.

Mr. HARDY: Bye, bye.

ELLIOTT: Lee Hardy emerges from the exam room after an hourlong consultation.

Mr. HARDY: This place is a blessing. And Im going to recommend it to a lot of people and I certainly do know a lot of folks who would probably qualify for the services.

(Soundbite of laughter)

Mr. HARDY: Because a lot of people that I know are employed and not insured. And thats the reality of the New Orleans that we live in.

ELLIOTT: The clinic has signed up 15 members so far. And the newest is contractor Fernando Arriola who says the clinic will help him with routine matters like his blood pressure. But hes still concerned about major medical issues. His plan for now?

Mr. ARRIOLA: Pray that nothing happens.

ELLIOTT: At least not until hes 65 and qualifies for Medicare.

Debbie Elliott, NPR News, New Orleans.

NORRIS: Are You Covered is about the health care experience of ordinary Americans. Its produced in collaboration with Kaiser Health News, a nonprofit news service.

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