Chris and Vickie Cox's health insurance never covered the full cost of treating their children's bone-marrow disorder. They relied on donations from their church, neighbors and family to plug the holes in their coverage, which ran as high as $40,000 a year.
That safety net is now unraveling. The slumping economy is pulling down fragile networks of support that in better times could keep families with insurance but big bills from falling into a financial hole.
The three Cox children have a rare disease called Shwachman Diamond Syndrome, which curtails the production of bacteria-fighting blood cells and digestive enzymes needed to absorb nutrients properly. It can lead to life-threatening infection, bone-marrow failure or a deadly form of leukemia.
After Samuel, 7, Grace, 12, and Jake, 15, were diagnosed with the genetic disease earlier this decade, landing a job with good health benefits became the biggest priority for Mr. Cox. He gave up plans to run his own home respiratory-care business to work as a salaried medical-equipment salesman. In 2006, the family moved to North Carolina from Kansas City to be closer to specialists at Duke University.
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