For 50-year-old Baraboo resident Chuck Slinde, it all started with a day in May when he couldn’t stop vomiting, not even after his stomach was completely empty. He had no other symptoms, just intense nausea, and was throwing up two or three times an hour.

After doctors at St. Clare removed his appendix, to no avail, the diagnosis came from specialists in Madison.

Chuck, who worked third shift as a janitor at Madison Area Technical College, had very serious gastroparesis, an "unlucky" complication of the insulin-dependent diabetes that, his doctors said, he had been managing well.

There’s no cure, and damage to his digestive system means food doesn’t move through easily on its own.

"All the nerves in his stomach are essentially dead," said his wife, 62-year-old Cheryl Slinde.

Chuck is on a very restricted diet, takes more than a dozen medications and special dietary supplements, and still can’t go more than a few days without debilitating nausea.

"You can’t eat and when you stand up you just want to throw up all the time, so you just kind of lie down a lot," he said.

It’s bad enough that several days of hospitalization are often necessary until he can stop vomiting.

In 2008, Chuck spent every major holiday in the hospital — Thanksgiving, Christmas, and New Years’ Eve and Day. In December last year, he was placed in a semi comatose state for a week, because nothing else was working. Shortly thereafter, he had a gastric pacemaker installed, which was supposed to help by telling his stomach not to be nauseated. So far, the device’s power has been turned up twice, but Chuck’s condition has just worsened.

Chuck, who was also holding down an additional job at a hospice and working more than 50 hours a week total, kept working whenever he felt able.

"I’ve worked my whole life," he said. "I’ve always been pretty much on the go all my life, often working two jobs."

In October, he was hospitalized for two weeks, and Cheryl had to quit her job as a concierge to take care of him. And Chuck’s doctor told him he would never be able to work again, because it exacerbated his condition too much.

The Slindes, who were paying $38 per month in health insurance premiums when Chuck was working, were shocked when MATC sent the numbers for continuation coverage through COBRA — if both of them were going to stay on his medical and dental plan, it would cost more than $1,300 per month, more than a third of the couple’s before-taxes monthly disability income.

"That’s more than most people pay for a house payment," Cheryl said.

Because Chuck’s medications make it difficult for him to focus, Cheryl has taken on the work of finding them affordable insurance.

"I have just spent hours and hours, and just gotten madder and madder," she said.

She quickly found public options to be no help. The Slindes make barely 250 percent of the federal poverty level for a family of two, and had to sell their house in Waunakee several years ago after Chuck was unexpectedly let go from his job at an insurance company. They’ve used up the equity from the house, and this month had only a few hundred dollars leftover for food and gas, even after leaving some bills unpaid.

But between their two sets of disability payments, the couple makes too much for the full-to-capacity Badgercare program, and about $200 too much for Medicaid. Once Chuck is approved for Social Security Disability income, a process which can take anywhere from a few months to several years, he’ll still have to wait 24 months from that date to start receiving Medicare benefits.

"Someone at the county level suggested we get a divorce," Cheryl said, emotional and, at times, crying.

"We’ve been married 27 years," she said. "Isn’t awful that you even have to think that?"

Chuck said it wasn’t fair to even consider cheating the system like that, "just to get benefits."

"We’re slipping through the cracks," Cheryl said. "Health care as we know it is falling apart."

She’s e-mailed the offices of Russ Feingold, Tammy Baldwin, President Barack Obama, and even documentary filmmaker Michael Moore. So far, Moore is the only one who hasn’t responded: Feingold and Baldwin’s offices have both promised to try to expedite Chuck’s application for Social Security, and Obama responded with a sympathetic e-mail that, while Cheryl suspects it was mostly written by staff, still touched her.

"I sat there and cried," she said. "It seemed very, very humane and very good."

While the state Department of Health Services estimated about 500,000 in the state of Wisconsin lacked health insurance in 2007, Citizen Action Wisconsin Executive Director Robert Kraig said it was more important to track "insurance insecurity," or the number of people who were uninsured for part of the year.

"The uninsured are much less likely to survive any major deterioration in health, to avoid treatment," he said. "Plus your whole financial future is at risk if there’s any major illness in the family. There’s an incredible amount of anxiety about that."

And that number is closer to 1.2 million, he said, and it’s going up.

The advocacy group Families USA estimates that 1,940 people in Wisconsin lose their health insurance every week, and that Chuck Slinde is just one of 70,000 Wisconsin residents to have lost coverage since the beginning of 2008.

Natalie Wilmot, the disability benefits specialist at Sauk County’s Aging and Disability Resource Center, said she faces cases like the Slindes "every single day."

"It’s the hardest part of my job ... to tell people that because of the dollar amount that they receive that they’re not eligible for health care," she said. "You’re looking at really emotional people who are looking at their lives falling apart, and there’s nothing you can do."

Cheryl Slinde recounts an episode in her search for private insurance, in which an agent had tried to pressure her into signing quickly onto a policy which he said would cover everything they needed, but which her research revealed would leave most of Chuck’s needs uncovered.

"He lied to us," she said. "It makes you very leery."

Meanwhile, she said, another agent with a different company had been more frank, and said Chuck’s condition would almost certainly lead most private insurers to exclude them, and those that wouldn’t would charge high premiums.

"He told me, ‘It’s going to be real tough for you people to get insurance,’ " she said.

Part of the problem, Cheryl said, is just knowing what the options are. MATC didn’t volunteer that Chuck might be eligible for a 65 percent discount on COBRA rates under the American Recovery and Reinvestment Act, for example — she found out from a private insurer, and is still waiting for confirmation from MATC that they can get that benefit.

Confusion with the system is a common problem, Wilmot said, noting that despite her training and experience, even she had difficulty sometimes.

"It is a very tangled web and they don’t make it easy to understand either," she said. Often, the solution for those without comprehensive coverage would involve several different types of assistance, ranging from prescription assistance to different branches of Medicaid and Medicare.

Michael Lew, who coaches Sauk County residents about medical assistance for prescription drugs, said it was "a travesty" how the system worked for the uninsured.

Counting the number of steps a person might take to meet all their health needs, he said, "They saw someone in Economic Support, they saw the Aging and Disability Resource Center, they saw me, and they saw a nurse. If you count up all of our time and our salaries, this is not cheap."

Disability Rights Wisconsin executive director Lynn Breedlove said that, as complicated as the situation in Sauk County was, it was tougher in counties where there are no publicly-funded resource centers.

While some residents of those counties might hire lawyers to help them navigate the process, many couldn’t afford that option, Breedlove said, and remained ignorant of their eligibility for different types of assistance.

"A lot of people there just don’t have anyone they can go to," he said.

Since beginning the process, the Slindes have a bit more hope. In January, Cheryl will be eligible for partial Medicare coverage. And if they receive discounted COBRA, their total expenses will be closer to $500 per month — less than half the original estimate.

Cheryl is looking for work, and while she’s worried about what will happen when Chuck needs to go to the hospital again, she said, they’ll have to make it work somehow.

But, she said, there’s still the question of what happens in September, when the discount would expire, and meanwhile $500 extra doesn’t currently exist in their budget.

Chuck said he thinks even the federal reforms, which the U.S. Senate began debating Monday, might come too late to help him.

"I’m scared," he said. "I don’t know what will happen if I don’t take my medications."

In the end the Slindes, both practicing Catholics, take some comfort in prayer.

"We’ve seen some tough times, but we always come out smelling like a rose," Cheryl said. "We’re just going to have to really trust only in God."