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Patients wait in line March 12 at the El Monte Comprehensive Health Center in El Monte, Calif. State health care systems have been increasingly strained by the rising number of uninsured Americans.
updated 10/31/2003 6:04:33 PM ET 2003-10-31T23:04:33

The ranks of the uninsured swelled by 2.4 million last year as insurance costs kept rising and more Americans lost their jobs and health care coverage. The number of people without health insurance the entire year rose to 43.6 million, a jump of almost 6 percent from 2001 and the second consecutive annual increase, the Census Bureau said in a report released Tuesday.

The percentage of Americans without health coverage rose from 14.6 to 15.2.

The bureau reported a survey last week that found more people fell into poverty and median income declined in 2002, even though the recession officially ended in November 2001.

Reflecting the broad scope of the recession and its aftermath, significant increases in uninsured rates occurred among whites, blacks, people 18-to-64, and middle- and higher-income earners. Rates increased in all regions of the country except the West.

A survey released this month from the Kaiser Family Foundation, a health policy research group, found that private health premiums increased 13.9 percent between 2002 and 2003. A family policy, on average, cost $9,068.

Poor economy to blame
Loss of coverage stemming from layoffs and scaled-back benefits was primarily to blame, Census Bureau analyst Robert Mills said. In 2002, 61.3 percent of U.S. residents were covered under an employment-based policy, down from 62.6 percent in 2001.

Health and Human Services Secretary Tommy Thompson noted that the uninsured rate for children was relatively unchanged at 11.6 percent. Expansions in coverage in two programs aimed at covering the poor and children — Medicaid and the state Children’s Health Insurance Program — “helped ease the impact of the economic slowdown,” Thompson said.

The White House pointed to other proposals in President Bush’s 2004 budget request, such as $89 billion in health care tax credits to help those who do not have employer-based coverage, as ways to get more people covered.

“The president is committed to getting the economy growing faster so the number of unemployed and uninsured Americans will go down,” Bush spokeswoman Claire Buchan said.

But John Holahan, a health care policy expert at the Urban Institute, a liberal-leaning think tank, said increases through Medicaid and CHIP haven’t helped lower- and middle-income adults out of jobs but are ineligible for public assistance.

“When you have a system that’s so dependent on employers, it’s hard to expect employers to maintain health insurance when they are trying to maintain their business,” Holahan said.

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“This is the second punch of the double whammy — you lose your job, then you lose your health insurance,” said Rep. Pete Stark of California, senior Democrat on the Joint Economic Committee, blaming the insurance losses on the “Bush jobless recovery.”

The latest data comes amid recent signs of an economic resurgence. The Commerce Department reported Monday that consumer spending rose a strong 0.8 percent in August after a 0.9 percent surge in July.

Americans’ disposable incomes, or what’s left after taxes, also rose 0.9 percent in August after a 1.5 percent jump the previous month. The government credited the increase to Bush’s tax cut, which lowered federal tax withholdings and boosted people’s take-home pay.

Those trends would not be reflected in the latest Census Bureau estimates based on a survey of 78,000 homes between February and April of this year. The questionnaire asked about a person’s health coverage in the previous year.

Largest increase in a decade
The 6 percent rise in uninsureds marked the biggest jump since a 9 percent increase between 1991 and 1992. However, Census Bureau officials warned that data before and after 1999 were not fully comparable because of survey changes with more detailed questions about health coverage now being asked.

Among racial and ethnic groups, blacks and whites appeared to have the most significant increases in uninsured rates. In 2002, about one-third of Hispanics were uninsured, compared to one-fifth of blacks and one-tenth of whites.

All age groups except for children and the elderly, and households at all income levels except for those making less than $25,000 a year, had increases. So did people of all educational levels except non-high school graduates.

Sen. Jim Talent, R-Mo., said Monday he hoped the new numbers could renew interest in a bill that lets small businesses band together through national trade associations to offer insurance for employees. The bill has passed the House but stalled in the Senate.

Meanwhile, many Democrats have criticized a Bush administration proposal to give states more power and flexibility to shape Medicaid programs as disguise to reduce funding at a time when dozens of states face severe budget crunches.

Providing temporary subsidies to recently laid-off workers to pay for private health insurance could also help get more people covered, said Ron Pollack, executive director of Families USA, a liberal advocacy group that focuses on health care.

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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