msnbc.com news services
updated 4/26/2006 11:00:02 AM ET 2006-04-26T15:00:02

The percentage of working-age Americans with moderate to middle incomes who lacked health insurance for at least part of the year rose to 41 percent in 2005, a dramatic increase from the 28 percent in 2001 without coverage, a study released on Wednesday found.

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Moreover, more than half of the uninsured adults said they were having problems paying their medical bills, with 20 percent of working adults paying off medical debt —often $2,000 or more, according to a report by the Commonwealth Fund, a New York-based private, health care policy foundation.

The study of 4,350 adults also found that people without insurance were more likely to forgo recommended health screenings such as mammograms than those with coverage, and were less likely to have a regular doctor than their insured counterparts.

The report paints a bleak health care picture for the uninsured.

“It represents an explosion of the insurance crisis into those with moderate incomes,” said Sara Collins, a senior program officer at the Commonwealth Fund.

Collins said the study also illustrates how more employers are dropping coverage or are offering plans that are just too expensive for many people.

About 45.8 million Americans did not have health insurance in 2004, according to the U.S. Census Bureau.

The percentage of individuals earning less than $20,000 a year without insurance rose to 53 percent, up from 49 percent in 2001. Overall, the percentage of people without insurance rose to 28 percent in 2005 from 24 percent in 2001.

Jump in uninsured 'alarming'
“The jump in uninsured among those with modest incomes is alarming, particularly at a time when our economy has been improving,” said Commonwealth Fund President Karen Davis, who helped write the study.

“If we don’t act soon to expand coverage to the uninsured, the health of the U.S. population, the productivity of our workforce, and our economy are at risk.”

The study also found that 59 percent of uninsured with chronic conditions such as asthma or diabetes either skipped a dose of their medicine or went without it to save money. One-third of those in that group visited an emergency room or stayed in a hospital overnight or did both, compared to 15 percent of their insured counterparts.

Collins said those statistics are significant because giving up medicines typically leads to more expensive health problems later. Treating people in expensive settings such emergency rooms places a financial burden on the health care system, she added.

“People not being able to take care of themselves should send out a big red flag,” said Collins.

The group, which does the survey every other year, also found that 67 percent of the 48 million going without insurance were in families where at least one person worked full-time.

The Commonwealth Fund’s study was bolstered by analysis of government data funded and released by the Robert Wood Johnson Foundation, a private organization that provides health care grants.

That study found that cost prevented 41.1 percent of uninsured adults from seeing a doctor, compared to 9.2 percent of individuals with coverage.

Meanwhile, 51 percent of women without health insurance haven’t had a mammogram in two years, compared to 22.8 percent of women with insurance.

And 76.3 percent of uninsured men between the ages of 40 to 64 haven’t had the PSA test, which detects prostate cancer, in two years. That compares to 52.2 percent of their insured counterparts.

Researchers at the University of Minnesota School of Public Health used data from the U.S. Centers for Disease Control and Prevention to reach the study’s conclusion.

The Fund, a private research group focusing on health care issues, surveyed more than 4,000 people by telephone for the report.

'A downward spiral'
It found that people without health insurance were more likely to go without recommended cancer, cholesterol and blood pressure screenings. For instance, 18 percent of adults aged 50 to 64 who lack insurance had a colon cancer screening in the past five years compared to 56 percent of insured adults.

“For an uninsured person who is unlucky enough to get sick, it is easy to see how quickly they can fall into a downward spiral of debt, forgone care, and poorer health,” Collins said in a statement.

The study found that 21 percent of the adults surveyed between August and January had unpaid medical bills.

The Associated Press and Reuters contributed to this report

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