updated 12/12/2003 1:45:44 PM ET 2003-12-12T18:45:44

Many disabled Americans have trouble paying for health care _ skipping medication, doing without needed equipment or postponing care _ though most have health insurance, according to a new survey by the Kaiser Family Foundation.

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While attention has been focused on older Americans and the choices some face between food and medicine, the survey found that non-elderly adults with permanent disabilities confront similar hardships.

Nearly half said they go without equipment, while more than a third said they postpone care, skip doses or split pills because of cost. A third of those surveyed also said they spend less on such basics as food and heat to pay for health care.

The foundation polled 1,505 adults between 18 and 64 with permanent physical or mental disabilities. It published the findings Friday.

There are about 15.5 million disabled adults across the nation, the foundation said.

"Nowhere is the case for providing adequate insurance for people who need it more compelling than when it comes to people with disabilities," Kaiser chief executive Drew Altman said. "This study shows that when the disabled fall through the health insurance cracks, they fall hard."

Other studies have found that more than 2 million disabled adults, about 13 percent of that population, are uninsured. Only 5 percent of those surveyed by Kaiser said they lack any insurance.

But among this group, most reported that they have no regular doctor and go without equipment and medication.

The survey findings also pointed up an issue that has received much attention lately _ the gap in coverage under Medicare, the government health insurance program for older and disabled Americans.

The Medicare law signed by President Bush Monday includes a new prescription drug benefit.

Among disabled adults with some insurance, those with Medicare and no supplemental insurance were most likely to have trouble paying health care bills. For example, more than half said they cannot afford their prescriptions.

Copyright 2003 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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