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The number of people without health insurance rose in 2002 by 2.4 million to 43.6 million, the U.S. Census Bureau reported last week.

That translates to an estimated 15.2% of the population with no health insurance coverage in 2002, up from 14.6% in 2001, according to the Census Bureaus report, “Health Insurance Coverage in the United States: 2002.”

The increase in the ranks of the uninsured is attributed in part in the report to a drop in the percentage of people covered by employment-based health insurance from 62.6% to 61.3%.

However, the number of people with health insurance also increased–rising by 1.5 million between 2001 and 2002, to 242.4 million, according to Census figures.

Both increases can be “attributed largely to an overall population growth from 2001 to 2002,” the report says.

More people have health insurance because more are covered by government health insurance programs. That figure rose in 2002, from 25.3% to 25.7%, largely as the result of an increase in Medicaid coverage. But this increase was not enough to offset the decline in private coverage caused by job losses and employee benefit cutbacks.

Donald Young, president of the Health Insurance Association of America, Washington, predicts that as the economy rebounds, the number of people with private health insurance will grow.

But, he thinks double-digit increases in health care costs will put continuing pressure on both private, employer-backed health insurance and on public programs like Medicaid and State Childrens Health Insurance Program.

“Affordability remains the number one reason people lack health coverage today,” he said in a prepared statement.

The HIAA suggests avoiding “costly” new mandates or regulations and providing tax incentives to “help small employers and moderate income workers better afford health insurance coverage.”

The Robert Wood Johnson Foundation, Washington, is helping organize “Cover the Uninsured Week,” a mobilization effort meant to make the issue of the uninsured a central part of national discussions through public education and community events.

The week, planned for May 10-16, 2004, is headed by both the foundation and a group of former surgeons general and presidents including Jimmy Carter and Gerald Ford.

Among the planned events are community health fairs, educational forums, workshops for small business owners seeking to maintain health coverage for their employees, and volunteer efforts by physicians and others, the foundation says.

Ronald Pollack, executive director of the consumer group Families USA, Washington, said in a prepared statement that the growth of the numbers of the uninsured is the largest increase in a decade.

“The increase in the number of people without health coverage is the direct result of our weak and job-losing economy,” he said. “This increase was caused by unemployment growth, double-digit health cost increases, and employers–who find spiraling health costs to be unaffordable–passing on more and more of those costs to their workers.”

The passing on of costs has been noted by the American worker, according to a recent Employee Benefits Research Institute survey.

It says fewer and fewer employees are confident their employers will continue offering health insurance in the years ahead. A growing number thinks a system of government coverage would work better.

The sixth annual Health Confidence Survey was released last week by Washington-based EBRI and Mathew Greenwald & Associates Inc., also based in Washington.

Between 2000 and 2003, the percentage of Americans with employment-based health benefits that are extremely or very confident their employer will continue to offer coverage fell from 68% to 61%, the survey says.

In the past year alone, the proportion of those with employer coverage who express a preference for a government-operated system jumped from 17% to 31%. But, 55% of those in employment-based plans continue to believe the employment-based system is best, the survey says.

Among all Americans, support for a government plan jumped from 25 to 36% in the past year.

The survey finds that Americans generally remain satisfied with the medical care they are receiving, but increasingly are uncomfortable about rising costs.

In 2003, 48% said they were dissatisfied with health costs not covered by insurance, up from 37% in 1998. A comparable group, 44%, was unhappy about the cost of health insurance, up from 32% in 1998.

These cost concerns may explain why a number of Americans say health care is one of the most critical issues facing the nation today (20% say it is the top priority), according to the survey.

Among other Census Bureau findings is that the proportion of insured children did not change in 2002, remaining at 64.8 million, or 88.4% of all children.

Although Medicaid insured 14 million people in poverty, another 10.5 million people representing 30.4% of those in poverty had no health insurance in 2002; this percentage was unchanged from 2001.

Young adults (18 to 24 years old) were less likely than other age groups to have health insurance coverage-70.4% in 2002. This compares with 82.3% for those 25 to 64 years old and 99.2% for those 65 and over, reflecting widespread Medicare coverage.

While most children (67.5%) were covered by an employment-based or privately purchased health insurance plan in 2002, nearly one in four (23.9%) was covered by Medicaid.


Reproduced from National Underwriter Life & Health/Financial Services Edition, October 3, 2003. Copyright 2003 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.