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She does a juggling act to insure her family

One in a series of profiles of Tampa Bay families and businesses and how health care reform will affect them.

Sharon Barbery, 32, works full time for a big state bureaucracy. That means a generous insurance package, right?


At the state Department of Health and Rehabilitative Services where Barbery works as a welfare interviewing clerk, she would have to pay nearly 10 percent of her salary for insurance premiums for herself and her family.

She can't afford it. Millions of other working Americans can't afford their employee health plan premiums either.

Barbery, a single mother, buys insurance for herself and relies on Medicaid, the joint state-federal health insurance program for the poor, to take care of her children.

One of the biggest challenges facing President Clinton in designing a health plan is to make it affordable to low-income workers like Barbery without socking the middle class with a heavy tax burden. Health insurance has priced itself out of reach for families like Barbery's.

To get health insurance through work for herself and her two children, Barbery would have to pay $46.79 every other week, for all but two pay periods. That would come out of her biweekly salary of under $500 _ even less, after taxes.

Since she can't afford that, Barbery says, she buys individual coverage for herself in an HMO for $13 every two weeks. Her children _ Tiffany Kelty, 8, and Rashad Kelty, 5, are enrolled in Medicaid.

Barbery said she wouldn't mind buying insurance that included her children and not herself. "I would go sick if I had to, as long as my children were taken care of," she said.

But that's not an option. With two children, she would wind up paying the full $46.79 for the family plan.

She likes the care her children get through Medicaid. But she lives with the fear that one day, the state will take away the free insurance.

She has been told several times over the years that she might have to pay a $425 "share-of-cost," a sort of deductible, for Tiffany's care before Medicaid would kick in. The thought alarms her because Tiffany has asthma, which can be a killer if not quickly treated.

"At least once a month she gets sick," Barbery said. "She takes Ventolin (a prescription inhaler) and she needs breathing treatments."

So far, Tiffany has managed to escape share-of-cost. But the complicated and often-changing Medicaid rules have made it difficult for case workers to give Barbery accurate predictions for the future.

A few days ago, an HRS Medicaid specialist reviewed the case and said Tiffany appears to be covered.

That's the outcome Barbery is hoping for. But given the uncertainty these last few months, she has been preparing for the worst.

She said, "I'm trying to keep enough of her medicine so that when the time comes, I'll be ready."