Health care reform isn’t just about covering the uninsured. It’s also about making sure that those who do have insurance can rely on it to pay the bills if they get sick, without leaving them with unmanageable debt. Sadly, that’s often not the case today, as Kaiser Health News documents in a series of reports done in partnership with National Public Radio.

The struggles of Jim and Martha Martin and their teenage daughters Sara and Rebekah, profiled in one of the articles, show how inadequate insurance can be. The parents, who live in Maine, hold down five part-time jobs between them yet have only limited coverage, mainly Martha’s plan (which only covers her) from her part-time supermarket deli job, and Sara’s through a student policy offered by her college. It’s nowhere near enough.

More medical bills are coming. Martha needs to have a hysterectomy next month, and she says her insurance will pay only $1,000 of the hospital bill.

For the Martins, 2009 is starting to look a lot like 2008. Last year they paid $6,210 in health insurance premiums for themselves and daughter Sara, plus another $13,955 in uncovered hospital bills after Rebekah's surgery.

It added up to almost 45 percent of their total income of $44,815.

We’ve explored the dilemma of the underinsured repeatedly in the past several years (see our health insurance reports from 2007 and 2009). Right now we’re in the process of analyzing the reform bills under consideration in Congress to see if they will give real relief to hardworking, struggling families like the Martins.

—Nancy Metcalf, Senior Program Editor