Jim Eyler, 58, and Jacque Eyler, 57, in June of 2005 before her diagnosis—when they thought their insurance was more than adequate; after the diagnosis, when Jim shaved his head to show support for his wife; and the Eylers in a recent photo with their dog. Photos courtesy the Eylers.

“I was healthy,” says Jacque Eyler of Westminster, Md. “I thought we were in a good place—that if anything happened we would be OK.” And why shouldn’t she? Jacque, 57, and her husband, Jim, 58, worked hard, paid their bills on time and saved money. Solidly middle class, these high school sweethearts are the kind of people who lived comfortably, but not beyond their means, in a house in the small town where they grew up. Then a diagnosis of cancer changed the Eylers’ life in ways they never could have imagined, let alone planned for.

Now Jacque and Jim live month to month and are fighting to stay afloat financially—almost as hard as she has had to in fighting her cancer. “If you ever told me I’d be in this situation, I’d say, no way!” says Jacque.

Unfortunately, the Eylers’ story is profoundly common. Lost amid the rhetoric about health care reform is the fact that tens of millions of people in this country are underinsured, and they probably don’t realize it. They march through lives under the treacherously false notion that they’re covered. If they’re lucky—that is, healthy—they’ll never have to put the limits of their health insurance to the test.

In August 2005, Jacque, a former private investigator with an agency, was devastated to learn she had an aggressive form of breast cancer known as HER2-positive. But she and Jim were comforted, knowing they had access to some of the best cancer specialists in the country at the Johns Hopkins Hospital, just 45 minutes away in Baltimore.

And they were confident that they could rely on their health insurance. Indeed, they’d opted for the best plan available through Jim’s employer, a cement manufacturer. The Eylers had no serious health issues, but they had agreed it would be worth the extra cost to be able to choose their own doctors if they faced a real medical problem. Under their policy, they’d have to pay 10 percent of the medical bill for that privilege. But when Jacque was diagnosed, that seemed like a bargain as they sought out the best experts to treat her complicated illness.

Soon, however, it became clear that even with their insurance, they wouldn’t be able to afford her care on Jim’s salary as a supervisor for the company. Their portion of the bill for the first year of treatment alone totaled nearly $20,000, roughly a quarter of what Jim earns.

No rest for the weary middle class

When Jacque learned she had a large cancerous tumor in her breast and that the cancer had spread to her lymph nodes, she tried to accept her new reality, including the high recurrence rate of HER2-positive breast cancer. She felt grateful for the attention she received at her regular chemotherapy appointments. But her troubling diagnosis and her expensive care were just the beginning of the challenges that lay ahead.

1 | 2 | 3