For the better part of four decades, thoughts about health insurance rarely crossed the mind of Rachel Stegeman. She worked. Her husband worked. Bills were submitted, doctors appointments scheduled and life’s routines stayed perpetually in motion.
In fact, years of hard work were coming to a close. In April 2006, at the age of 61, Stegeman, who lives just outside of Charlottesville, filed for Social Security. Her husband, a local construction superintendent, made good money. His job provided health insurance for both of them.
Rachel Stegeman unexpectedly found herself one of 47 million Americans without health insurance.
Until it didn’t. Three months later, in the midst of separating from her husband, Richard, Rachel suddenly found herself in a situation more and more Americans are dealing with. Richard had moved out and unexpectedly retired, leaving her without health insurance.
Feeling like a trapeze artist hundreds of feet up, Stegeman was now working without a net. She had just been diagnosed with diabetes.
Stegeman had become one of 47 million Americans without health insurance. Families USA, an advocacy group for health care consumers, estimated that of the 4.2 million people between the ages of 25 and 64 living in Virginia in 2006, a little over 15 percent of them were uninsured. Of those uninsured, more than 10 working-age Virginians died each week due to lack of health insurance, according to Families USA.
“It’s a known fact that people without insurance live sicker and die sooner than those with insurance,” says Erika Viccellio, the executive director of the Charlottesville Free Clinic.
Because she had filed for Social Security, Stegeman’s income was limited. And with her newly diagnosed diabetes, insurers shied away from covering her. Previously covered by AARP, Stegeman hoop-jumped and paperworked herself to near exhaustion, trying to get back on its insurance plan. No luck.
“I’ve been through a lot of red tape and paperwork with them, but I haven’t been able to get it,” she says. “[Diabetes] just seemed to make it more complicated.” After six month of doctors appointments, letters and tests she could barely afford, “finally, I just gave up, I guess. Here I was paying hundreds and hundreds of dollars to do these things, and finally it got to the point where I just couldn’t do it.”
So her employer, who is an annual donor to the Charlottesville Free Clinic, suggested she try the Free Clinic, which receives 2 percent of its funding from Charlottesville and Albemarle County, and 4 percent from the state. For almost a year, she has been going there for appointments for all her medicine—14 pills a day. All of it is free.
“They’re just diehards,” she says about the clinic’s doctors, all of whom are volunteers. “They stay and get it done.”
The 15-year-old Free Clinic treats working people who make enough money that they do not qualify for free treatment at UVA and Martha Jefferson hospitals but who don’t make enough that they can afford insurance. Its patients are housecleaners, waitstaff, child-care providers, construction workers and part-time workers like Stegeman who don’t have health benefits.
The clinic saw roughly 1,500 people last year, and while the number of patients increases each year, the frequency of treatment for those patients has increased five fold over 10 years. Most patients come in for multiple appointments, and those appointments are taking more and more time.
“There has been a real shift in the type of care our patients need,” says Viccellio. “Most of our patients now have multiple chronic diagnoses.”
The number of prescriptions that the Free Clinic provides has gone up 600 percent since it opened, says Viccellio. She attributes the increase to patients’ lack of access to preventative care. According to Families USA, uninsured adults are more than 30 percent less likely than insured adults to have had a checkup in the past year and are most likely to be diagnosed with a disease in an advanced stage.
“Rather than coming in to get an antibiotic and be done,” says Viccellio, “they’re coming in for all these medications to manage their illnesses. There are so many more layers to what we’re doing now.”
Viccellio says more and more middle-income workers are coming in without insurance, just like Stegeman, who is waiting until she turns 65 and will be covered by Medicare.
“I’m probably the only woman in the United States,” she says, “that’s wishing to be a little bit older.”
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