Cover America Tour rolls through Portsmouth

When Ashland resident Chuck Engborg’s wife got laid off about a year ago, it forced the couple to make some unpleasant decisions. Engborg, who suffers from a variety of health conditions related to diabetes and heart disease, had previously been laid off by the same company. Since then, he had been insured by his wife’s employer-provided policy. When that disappeared, the family turned to their COBRA (Consolidated Omnibus Budget Reconciliation Act) option to cover their full premium.

“With the cost of that COBRA option, medical expenses, doctors, hospital visits, blood work and all that, we’ve been spending over 50 percent of our monthly take-home income on health care costs,” Engborg said.

No longer able to pay for their necessities, the Engborgs were left with the odious options of taking their medicine or keeping their house. They chose to jeopardize their health by cutting back on medications. But paying the monthly bills still proved to be a major challenge, and they quickly drained $15,000 from their retirement fund.

“Our golden years are not looking so golden anymore,” he said.

Engborg’s tale is one of thousands of health care horror stories that have emerged across the country. Consumer Reports Health has embarked on a national tour to listen to Americans share their grievances about the health care system, posting online videos and blogs along the way. The Cover America Tour RV made one of its early stops in Portsmouth’s Vaughan Mall on June 3, at which time Engborg addressed a group of healthcare advocates, legislators and media members.

“These are the stories that need to be out there when people start talking about health care reform,” said Meg Bohne, campaign organizer for Consumers Union, the nonprofit, nonpartisan organization that publishes Consumer Reports Health.
The Cover America Tour began in late May, leaving from Consumer Reports’ headquarters in Yonkers, N.Y. The four-month tour will travel from coast to coast before returning to Yonkers in September. Videos, photos and blogs will be posted at www.coveramericatour.org throughout the trip. When the tour is over, the team will take its amassed stories to Washington, D.C., to push for federal action.

“Legislators understand stories,” Bohne said. “It’s the stories themselves, the personal experiences, that are compelling.”
State Sen. Martha Fuller Clark (D-Portsmouth), a member of the Health and Human Services Committee, said she has already heard a barrage of such stories from her constituents. She spoke of couples in their 50s who must pay upwards of $30,000 per year for health insurance. Although New Hampshire has made progress on health care, the problem is still devastating, she said.

“We may have prevented health insurance companies from refusing outright to cover individuals with pre-existing conditions, but we haven’t prevented them from driving families into bankruptcy,” Fuller Clark said.  

According to Consumer Reports Health, New Hampshire is behind the rest of the nation in many health care statistics. Workers in the state who get insurance through their jobs contribute an average of 23 percent of the premium ($965), which is 5 percent ($242) higher than the national average. Family health insurance premiums from job-related coverage in New Hampshire cost workers an average of $2,882, which is $297 over the national average. From 2002 to 2005, family premiums in the state rose by 12.7 percent, while median earnings of employees purchasing family coverage dipped by 1 percent. Close to 138,000 residents, or 11 percent of the state’s population, are uninsured.

The state has made some significant strides over the last year, according to legislators. Gov. John Lynch recently signed into law the N.H. HealthFirst bill, which is aimed at helping small businesses afford health insurance for their employees. Fuller Clark and State Sen. Maggie Wood Hassan (D-Exeter) cosponsored the legislation.

“That will require all insurers in the state of New Hampshire to offer the small businesses an insurance product that is based on a wellness program,” Hassan said.

Many large employers, she said, have already taken advantage of these programs. Employees who participate in certain wellness activities see their premiums cut by 10 to 15 percent. But smaller employers do not have the infrastructure or bargaining power to get such benefits from insurers.

“This piece of legislation will put them on the same footing with large employers to be able to take advantage of wellness programs,” Hassan said.

Fuller Clark pointed to two pieces of legislation that passed in New Hampshire last year. One bill enabled people between the ages of 18 and 25 to remain on their parents’ health insurance plans as long as they work in New Hampshire. Previously, people were automatically dropped from their parents’ plans at the age of 18 if they did not go to college. The second bill ensured that divorced spouses could stay on their family health insurance plans for up to three years after the divorce. Before that bill passed, Fuller Clark said, many couples were staying in bad marriages because they were afraid of losing their health insurance.

Fuller Clark said she has twice filed legislation to make the N.H. Department of Insurance hold a public hearing whenever a health insurance company wants to raise its premiums. The legislation was defeated both times.

Other improvements to enhance quality assurance and cost effectiveness are on the way, Hassan said. The state will start keeping digital records for all New Hampshire health providers within the next year, which Hassan predicts will lower health care costs by 10 to 15 percent. The state will also make digital prescribing available for all physicians.

But the problems are still multi-faceted. Many people have purchased plans under the false assumption that they would be protected in the event of certain catastrophic illnesses, only to find out later that they are not eligible for such coverage, Hassan said. She stressed the need for stricter regulation and encouraged voters to pay attention to the health plans pitched by presidential candidates of both parties. State legislators can only do so much, she said.

“The states have been very aggressive on this because the federal government has not been,” Hassan said. “The plan that goes to the White House will have much to say about the quality of life of every American citizen.”

Annie Farnsworth, executive director of the N.H. Women’s Lobby and a representative of N.H. Voices for Health, agreed. She encouraged residents to contact their legislators and vote for future leaders who will take serious action on health care. 

“We really need to have everyday people tell your representatives that you need something better, both here in the state and across the country,” Farnsworth said.

N.H. Voices for Health is a relatively new group of consumer and advocacy organizations that have aligned to fight for quality, affordable health care for every resident. The issue, Farnsworth noted, has affected everyone.

“Everybody has a health care story. Nobody is really immune. This is really tough,” she said.

Hassan noted that she has a 19-year-old son with cerebral palsy and other medical conditions that require him to see at least nine different doctors. Her family is insured through her husband, who is employed by Phillip’s Exeter Academy.

“I am reminded daily what my life would be like, what his life would be like, and the risk that he would be at if he didn’t have that health insurance, and I am reminded daily how tentative and fragile the availability of that insurance is for my family and other families like mine across the country,” Hassan said. “This is a problem that we can absolutely solve, we just have to work together to do it.”