For working people making modest wages and struggling with high medical bills from chronic disease, President Barack Obamas health care plan sounds like long-awaited relief. But the promise could go unfulfilled.

Its true that patients with cancer and difficult conditions such as multiple sclerosis or Crohns disease will be able to get insurance and financial help with monthly premiums.

But their annual out-of-pocket costs could still be so high theyll have trouble staying out of debt.

You couldnt call them uninsured any longer. You might say theyre underinsured.

These gaps need to be addressed in order to fulfill the intention of the Affordable Care Act, said Brian Rosen, a senior vice president of the Leukemia & Lymphoma Society. There are certainly challenges for cancer patients.

Cost may still be an issue for those in need of the most care, said Steven Weiss, spokesman for the American Cancer Society Cancer Action Network. That makes it critically important for patients looking at premiums to also consider out-of-pocket costs when choosing a plan.

Out-of-pocket costs include a health plans annual deductible, which is the amount before insurance starts paying, as well as any copayments and cost-sharing.

A few numbers tell the story. Take someone under 65 with no access to health insurance on the job and making $24,000 a year about what many service jobs pay.

Under the health care law, that persons premiums would be capped below 7 percent of his income, about $130 a month. A stretch on a tight budget, yet doable.

But if he gets really sick or has an accident, his out-of-pocket expenses could go as high as $5,200 a year in a worst-case scenario. Thats even with additional financial subsidies that the law provides to people with modest incomes and high out-of-pocket costs.

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Plans under health care law leave some 'underinsured'