The New Healthcare Crisis: When Having Health Insurance Isn't Enough

When Health Insurance Isn't Enough

Jennifer Anderson, a former high school track star, worked hard to take care of her body. She'd accepted an administrative position at Spalding University in Louisville, Kentucky, partially for its good healthcare plan -- not because she needed it, but because it was important to her. She thought it was a smart choice.

Soon after she started her job, her hands began to hurt, followed by her wrists and many of her joints. In 2002, when Jennifer was just 21, doctors diagnosed her with degenerative rheumatoid arthritis, a disease that threatened to leave her crippled in several years. A few months later, surgeons replaced one of her hips.

By that point the soreness was so extreme that she struggled to pick up her toddler son. Still, she vowed to do whatever it took to get better. Then, in the spring of 2003, Jennifer's determination was derailed for the most frustrating of reasons: Her insurance company denied her full coverage for Enbrel, the one drug her doctor said could stop the pain and slow the disease. As a working single mom earning $20,000 a year, Jennifer could not afford the $350 per month co-pay that her insurer told her she'd have to foot for the "specialty drug."

"I was shocked," she says. "This medicine was going to help me. How could they not cover it? Isn't that why I had insurance to begin with?"