The number of uninsured rose from 45 million in 2003 to 45.8 million in 2004 (15.7 percent of the population), the fourth straight year of increases. The number of uninsured has increased by 6 million since 2000.

The Physicians’ group noted that only a huge increase in the number of Medicaid enrollees – driven by an unfortunate increase in the number of people in poverty who were therefore Medicaid-eligible – prevented a much larger rise in the number of uninsured Americans; without the expansion of Medicaid and other public programs the ranks of the uninsured would have swelled by 3.1 million.

While the proportion of Americans covered by private health insurance declined (from 68.6 percent in 2003 to 68.1 percent in 2004), the number of Americans enrolled in Medicaid rose by 1.9 million (from 12.4 percent to 12.9 percent).

The new numbers reflect a continuation of the trend during the Bush administration of declining private coverage and rising poverty which has driven up the number of uninsured despite increases in the Medicaid population. Since 2000 Medicaid enrollment has swelled by 9.6 million (increasing from 10.2 percent of the population to 13 percent in 2004). States spent more on Medicaid in 2004 than on primary and secondary education combined.

“The new census numbers should wake up our politicians.” said Dr. David Himmelstein, Associate Professor of Medicine at Harvard Medical School. “More and more are uninsured, and the Bush Administration’s main strategy for increasing coverage is to drive more Americans into poverty so they can qualify for Medicaid. But Medicaid is second class coverage, often little better than being uninsured. Americans desperately need national health insurance.”

Middle-class Americans with incomes of between $50,000 and $75,000 were the fastest-growing group of uninsured, increasing by 616,000 individuals in 2004.

“The high cost of insurance premiums are forcing millions of middle-class Americans to forego coverage, and millions more find that their skimpy policies leave them vulnerable to high out-of-pocket costs and even bankruptcy if they are seriously ill,” Himmelstein said. “Most of the two million Americans affected by medical bankruptcies each year were middle-class. A middle income is no longer a guarantee of coverage or protection.”

PNHP National Coordinator Dr. Quentin Young said that a system of national health insurance was the only way to solve the problems in the nation’s health system.

“These cold figures can never measure the human suffering that results from being uninsured. It makes any illness a potential economic and social catastrophe,” Young said. “The Administration’s proposed reforms fail to address the systemic problems of the health system. Health savings accounts and tax credits will only intensify the failure. By contrast, the experience of other industrialized nations teaches us that high-quality, comprehensive care can be provided to all our citizens without increasing health spending. A single-payer national health insurance system has emerged as only solution to the nation’s health system debacle.”

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