Utah preschool:
Owner has to close down to get health insurance
Diane Knight and her family, Orem, Utah
Miss Diane’s Preschool
Orem, Utah
Founded: 1986
Employees: none
Health coverage: Regularly changing
Family finds itself uninsurable many years after treatment
Diane Knight has spent most of the past twenty years teaching young children in her preschool. While she continues to love the work, Miss Diane’s Preschool is closing because of her family’s difficulty getting health insurance.
Diane is taking a full-time job with the local school district so she can get health coverage for herself, her husband Alan and their two children. She and Alan, who is in sales, have each made big compromises in their careers so that at least one of them is always working for a large company that provides a good health plan.
This is despite good health all around—Diane, who is 51, maintains a healthy lifestyle. Alan runs marathons. The trouble is that both of them were treated for cancer in 2000. They’ve been healthy and cancer-free since then, but now find themselves completely uninsurable. “Over the past nine years we have become experts in the numbing reality of COBRA laws, certificates of creditable coverage and taking menial jobs just to maintain insurability,” Diane says.
"There are just too many cracks for hardworking people to fall through.” —Diane Knight
Teenager turned down because of acne cream
Diane learned the hard way about preexisting condition barriers for the self-employed. But she was still surprised when her teenage children’s health problems made them uninsurable as well. Twenty-year-old Brady had a lung collapse while exercising, but that is not rare among slim teenage boys, and has a low chance of recurrence. Meanwhile, 17-year-old Natalie was turned down for coverage because she was prescribed a topical acne cream two years previously.
When Natalie was referred to the state high-risk pool for the uninsurable, that was the last straw for Diane. “Having both parents deemed uninsurable because of cancer is bad enough, but lumping an otherwise healthy, athletic teenage girl in the same category is reprehensible,” she says.
Both Diane and Alan could follow their own entrepreneurial dreams if it weren’t for their inability to get insured. They can’t even work for small firms, because their health histories raise the rates for everyone in a small group. “Health insurance is not optional in this day and age, but it has become discriminatory,” Diane argues.
“What we desperately need is reasonable access to reasonable healthcare at a reasonable price.” —Diane Knight
Insurance struggles a constant source of stress
Diane Knight doesn’t favor a wholesale redesign of the healthcare system and US economy. She just wants access to healthcare coverage to be fairer, to allow small businesses like hers to stay alive and thrive. “What we desperately need is reasonable access to reasonable healthcare at a reasonable price,” she says.
Instead, a family that works hard to participate in the community and economy finds itself with few options. The constant struggle to maintain affordable coverage takes its toll. “Health insurance has become a major source of distress in our lives—ironically even more distressing than the fear of cancer itself,” Diane says.
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Two-thirds of small business owners in 16 states said in recent surveys that ensuring affordable health
coverage should be a shared responsibility.

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