AUDIE CORNISH, HOST:
From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.
MELISSA BLOCK, HOST:
And I'm Melissa Block. A little more than a year ago, we launched our Road Back to Work series. Since then, we've followed six people in and around St. Louis, Missouri, who began 2011 unemployed and searching for work. Well, today marks the end of our series.
CORNISH: Like so many Americans struggling in this tough economy, the people in our stories have had a difficult time finding work. As we'll hear today, many have also had a tough time finding affordable health coverage. And as NPR's Tamara Keith reports, the search for insurance doesn't always stop with a job offer.
TAMARA KEITH, BYLINE: Zumba - it's a fitness craze, a high-energy dance and exercise program in gyms and even the community center in Hazelwood, Missouri, where Casaundra Bronner lives.
CASAUNDRA BRONNER: This is Casaundra. I just got out of my Zumba class this evening and it was fun as always, but it's a lot of work.
KEITH: Bronner, like everyone we've followed, has been keeping an audio diary for the past year. She has fun doing Zumba, but as she tells the recorder, that's not the only reason she goes to this class.
BRONNER: Because I don't have insurance right now, it's even more important that I stay healthy and keep any potential problems at bay. I'm borderline high blood pressure. Both of my parents have diabetes and high blood pressure, so it's, you know, really important that I try to stay as healthy as possible.
KEITH: For the majority of Americans, health insurance is something that comes with a job. That's the way it always was for Bronner, until two years ago when she lost her job in the marketing department at Anheuser-Busch.
BRONNER: That's been kind of weird and different because I've had insurance for as long as I can, you know, remember.
KEITH: Bronner is 40 and has two daughters in elementary school. But just to be clear, she's one of the lucky ones. Bronner started working full time again back in March, but she still doesn't have health insurance. She works for a small event planning company and her boss says insurance is just too expensive.
BRONNER: I think if she gets to a certain place - and I don't know what that is 'cause that's her - she'll be able to look into some programs. But for now, she can't afford to have it. And she's married, so she's on her husband's, so she's covered.
KEITH: And on Bronner's salary, half of what she made in her last job, she can't afford to go out and buy it on her own. Her daughters are covered under a state program for the working poor.
BRONNER: I go to the doctor when I need to and I just pay out of pocket. But hopefully nothing serious will happen.
KEITH: Of the six people in our series, only one has had health insurance the entire time, and that's because his wife works as a teacher and he was able to get coverage through her plan. Everyone else has gone extended stretches without coverage. Even now, with everyone at least partially employed, half don't have insurance.
ANNICA TROTTER: Today is June 4th, 2011. My name is Annica Trotter and I'm headed to the emergency room.
KEITH: She's having chest pains. It's been happening for a few months, aching pain in the middle of her chest that radiates out to her shoulder. It hurts, it slows her down, and on this day, it flared up while she was doing housework.
TROTTER: At about 12:00, my chest just really started hurting, so I slowed down, then I just stopped cleaning completely, hoping that maybe it would go away, but it's not going away.
KEITH: Trotter is in the group that's having to do without. She had good coverage when she worked at a social services agency. But in her new job as a receptionist making $14 an hour, she says the insurance barely covers the basics. She says none of her co-workers signed up for it, and neither did she because the monthly employee portion is more than she can handle.
TROTTER: Not only am I worried about the pain that I'm having and how frequent it's been over the last couple weeks, I'm worried about the money. I can't afford this. I cannot afford this today. I just got paid yesterday. It goes in one hand and out the other. Paying rent, paying car notes, insurance and all that stuff, and I know that I cannot afford to go to the emergency room today.
KEITH: There's a history of cardiovascular disease in her family. She's frustrated and scared. She cusses into the recorder.
TROTTER: As soon as I think that I'm getting my ducks in a row, something like this happens. And I know that I put this off for a really long time and I feel like I can't ignore it right now, so I know I just have to go.
KEITH: Trotter doesn't take her recorder into the hospital. They perform lots of tests and ultimately tell her it's either a muscle strain or stress or both.
TROTTER: And I just had instructions to reduce stress and call back if things got worse.
KEITH: As she puts it, all she got out of the visit was a big fat bill. Eventually, the hospital agreed to reduce what she owed, but months later, she's still chipping away at the bill. And so, like Casaundra Bronner, she just hopes nothing else goes wrong. For 51-year old Randy Howland, the need for regular medical care is arguably even greater.
But he hasn't had insurance in a decade. He's had seizures in the past - even once, a long time ago, when he was driving.
RANDY HOWLAND: And that, you know, was a full collision. I hit a school bus. The school bus luckily didn't have kids on it. Our car was totaled. I was limping for quite some time.
KEITH: He takes medication for it, which he pays for out of pocket, and is supposed to get regular blood tests and other monitoring. But he rarely does. His attitude is almost fatalistic.
R. HOWLAND: Get that insurance and we'll get that looked at.
KEITH: But every time Howland has come close to getting insurance, he's either lost his job or realized that on 10 or $12 an hour, he simply couldn't afford it. On a number of occasions, he and his wife, Lisa, have chosen paying the mortgage over paying for insurance.
LISA HOWLAND: I worry about his medical condition, and I worry every day he gets in the car.
KEITH: This is Lisa.
L. HOWLAND: There's nothing I can do about it. I just have to get up every day, say my prayers and hope that somebody's watching out for us.
KEITH: This line of discussion clearly makes Randy uncomfortable. He pipes in and asks the last time his wife has gotten a mammogram. It's been years.
L. HOWLAND: I worry more about you than myself, dear, and you know that.
KEITH: Randy Howland just started a new job that pays a little better than the last one and he's hoping this time, finally, he'll be able to get insurance. Casaundra Bronner has started looking for a position with a company that offers insurance and she says employers seem much more responsive than when she was unemployed. And Annica Trotter? She's not sure what to do. Tamara Keith, NPR News.
CORNISH: To find out what happened to all six of the people in the Road Back to Work series, go to our website, npr.org. There you'll find bios, updates and links to previous stories in the series.
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