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Few exemptions
The government already exempts people who need kidney dialysis and those with Lou Gehrig's disease from the waiting period.

Economist Pamela Farley Short of Penn State University, who has researched the issue, said the waiting period should concern all workers.

"It's easy to think it's not going to happen to me," she said. "But when you follow people over time, just over 15 percent of those who are 55 are going to be on Medicare before they turn 65. That doesn't seem so trivial."

Nearly 7 million disabled people under age 65 are now covered through Medicare.

Of those still waiting for coverage, about 60 percent manage to hang on to private insurance. Many draw down their retirement savings to pay premiums through a previous employer's health plan. Others fall into poverty and are picked up by Medicaid. As many as one in three, like McClain and Frederick, wind up uninsured.

McClain was diagnosed with cancer a little more than two years ago. He was at work one night when he reached up to scratch his neck and felt a big lump. He hadn't been feeling particularly well for several months. The next day he started getting dizzy and went to the emergency room.

Eventually, the diagnosis came back: a tumor on his left tonsil.

McClain doesn't spare himself when it comes to blame. He started smoking cigarettes at 13, and, though he has cut down, has been unable to quit.

"I don't know how to say how stupid I am for still smoking," he said.

His cancer treatment has been arduous: Chemotherapy. Radiation. A feeding tube. Bouts of depression and anxiety. His weight dropped from about 150 pounds to 116. But the cancer seems to be retreating.

McClain has begun to feel his energy come back, and he yearns to go back to the machine shop. Yet he is worried about a small area in his throat. And he can't afford to pay for a scan because he lost his insurance at the end of October.

Spiraling toward bankruptcy
"I think I have around $22 in savings," he said. "After talking with my creditors and a debt management company, it sounds like bankruptcy. The funny part is, I have a perfect payment history to this day, and none of them can figure out how I made it this far."

Like McClain, Frederick, the former bakery manager, is spiraling toward bankruptcy.

Multiple sclerosis is a progressive disease in which the immune system attacks the protective covering around the nerves. It can lead to paralysis. Frederick was diagnosed in 2002.

"My MS affects my mobility," said Frederick, of Glen Burnie, Md. "I have shaky hands and legs. When I lay still at night, I can feel my muscles vibrate. It's like a dim humming and I can't sleep. I stretch my legs, and then I can't bend them."

Frederick had to leave the bakery because her hands shook too much to decorate cakes. Then, in the fall of 2007, she lost her fallback job as an event planner. Even with her disability check, she is behind on rent and utilities. Without health insurance, she can't afford an injection that costs around $3,000 each time and helps control her MS. She is supposed to get a treatment every three months. Her last was in July.

"They tell you to go to school and graduate and get a career," Frederick said. "I did all of that, so why is this happening now?

"I'm old enough to know that there are things in life that happen that aren't fair," she continued. "I was employed from when I was 15 to when I was 32. I worked my whole life and I paid into this fund."

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