Triple jeopardy: low income, chronically ill and uninsured in America.

At least 7.4 million working-age Americans with chronic conditions--such as diabetes, heart disease and depression--lacked health insurance in 1999, according to new research findings from the Center for Studying Health System Change(HSC). Uninsured people with chronic conditions report worse health and more functional limitations and are three times more likely not to get needed medical care compared to those who are privately insured. The vast majority of uninsured people with chronic conditions delayed or did not get needed care because of cost. About 63 percent of the uninsured with chronic conditions--roughly 4.7 million Americans--have family incomes below 200 percent of poverty, or about $35,000 a year for a family of four in 2001. Faced with the triple threat of low income, ongoing health problems and no health insurance, this group confronts great difficulty getting and paying for needed care.