When the debate isn't abstract at all

As the health care debate in Washington headed toward a climactic vote last weekend, Bob and Mary Drew of Afton were paying closer attention than most.

In the summer of 2008 Mary was diagnosed with cervical cancer and then, a few months later, Bob found out he had tonsil cancer. In between, Bob lost his job. Now their COBRA coverage is running out and the Drews are scrambling to find someone who will insure them.

The Drews embody the sort of insecurity faced by thousands around the country that led to Sunday's historic vote: What if I lose my job? What if I get sick? What if my spouse or kid gets sick?

"There are hundreds of thousands of stories like ours that are largely ignored," said Bob Drew, 57. Added Mary Drew, 64: "Until you're living the story."

If the Drews represent a natural constituency for the legislation, they also illustrate the peril facing its supporters. Some of the key provisions -- subsidies to buy insurance and robust protections for consumers -- don't fully take effect until 2014. That's not soon enough for Bob and Mary Drew. With the public deeply divided over the legislation's merit, the lag in visible, popular benefits might leave millions of Americans wondering if the epic political battle was worth it.

Four years ago, the Drews sold their townhouse in Maplewood, moved to Afton, and rented a two-bedroom apartment above a motorbike accessories store, with a view of the St. Croix River.

Bob was a engineer with a data storage company. Mary's job was closing real estate contracts, and she did well during the real estate boom. Both worked out of their home and as recently as two years ago, their annual household income hovered at $120,000.

Doctors caught it early and she went through chemotherapy and radiation, and seemed to recover.

That October, Bob Drew was laid off. After 11 years with one company he was back in the job market, scouring job openings online and competing with younger candidates. He signed on for COBRA, which allows former employees to stay on group coverage for a limited time.

Good thing, too. In April 2009, Bob found a lump on the side of his neck. "I thought: 'No, it can't be cancer,'" Mary recalled. "This can't happen to the same family."

But it did. Doctors removed 23 lymph nodes from Bob Drew and found cancer in only one. He went for radiation.

One day in May 2009, Mary Drew woke up "sicker than a dog." The radiation for her cervical cancer had perforated her bowels. She was rushed to a hospital. "He was in one hospital having surgery and I was in another hospital," said Mary.

Drawing down savings

But life is far from normal. Mary, who used to love to eat, now has to get all her nutrition through a port in her chest. Her daily nutrition packs, medication and nursing help are charged to their insurance company: $5,000 a week.

Still, she says she's grateful not to be in much pain. She can do little things: dusting, knitting, reading, watching the Food Network. She fantasizes about eating again someday: lobster, chicken chow mein, pizza.

In November, they found out her cancer had returned. Doctors said there was nothing they could do. They advised the Drews to start looking at hospice care.

Since Bob lost his job, they've drawn down their savings. The Obama administration's subsidies on COBRA premiums helped, bringing their premiums down from $1,064 to $368 a month. But that COBRA coverage runs out at the end of May.

He is baffled by the populist backlash against the health care bill: "Why would anyone be so vehemently against what's in their best interests?"

The Drews voted for Barack Obama. But since then Bob says he's been frustrated by the "spinelessness and lack of leadership in the Democratic Party" and "their inability to do stuff."

Mixed feelings

Last Sunday, Mary's son and grandkids dropped by to see them, as did Bob's sister. Between the visits, Bob checked news updates on the Web all day. After the House finally passed the Senate legislation, he was left with mixed feelings.

He's disappointed the bill will not include a government-run health plan, the so-called public option favored by President Obama and many Democrats.

Ultimately, "I'm surprised it happened at all," he said this week. "I'm not popping the champagne corks yet."

Because they live in Minnesota, the Drews do have an immediate health insurance option they may not have in other states.

While they're almost certain to be rejected for individual health insurance, they can apply for coverage through the Minnesota Comprehensive Health Association (MCHA), a subsidized high-risk pool. However, premiums are about 20 percent higher than a comparable policy in the individual market -- unaffordable for some.

The Drews applied for coverage from MCHA last week and are waiting to hear back.

For states without such an option, the federal legislation would establish a national high-risk pool within 90 days. It would operate until 2014, when insurers can no longer reject people with pre-existing conditions.

He's sent out "dozens" of job applications. So far, he's landed one interview.

Last week, he heard the job had gone to someone else. It would have paid a fraction of what he used to make, but he would have gladly taken it.

For the health benefits.