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Uninsured Swell to 15 Percent

By Robert Pear

The New York Times -- WASHINGTON

The number of people without health insurance shot up last year by 2.4 million, the largest increase in a decade, raising the total to 43.6 million, as health costs soared and many workers lost coverage provided by employers, the Census Bureau reported Monday.

The increase brought the proportion of people who were uninsured to 15.2 percent, from 14.6 percent in 2001. The figure remained lower than the recent peak of 16.3 percent in 1998.

A continued erosion of employer-sponsored coverage was the main reason for the latest increase, the bureau said. Public programs, especially Medicaid, covered more people and cushioned the loss of employer-sponsored health insurance but “not enough to offset the decline in private coverage,” the report said.

The proportion of Americans with insurance from employers declined to 61.3 percent, from 62.6 percent in 2001 and 63.6 percent in 2000. The number of people with employer-sponsored coverage fell last year by 1.3 million, to 175.3 million, even as the total population grew by 3.9 million.

Tommy G. Thompson, the secretary of health and human services, said the numbers showed that “the nation must do more” to help the uninsured. Thompson said that Congress should provide tax credits for the purchase of private insurance.

But no action is imminent. Congress is preoccupied with efforts to help a large, politically potent group that already has insurance, the elderly, by adding drug benefits to Medicare.

Ronald F. Pollack, executive director of Families USA, a liberal-leaning consumer group, said: “It’s hard to grasp the magnitude of the number of uninsured. It exceeds the aggregate population of 24 states.”

The number of full-time workers without health insurance rose by 897,000 last year, to 19.9 million. Kate Sullivan, director of health care policy at the U.S. Chamber of Commerce, said the increase was alarming and predicted it would continue this year.

“Workplace coverage is becoming unaffordable for many employers and employees,” Sullivan said.

On Friday, the Census Bureau reported that poverty rose in 2002 for the second consecutive year. The poverty rate generally declines when the economy expands, but there is no guarantee that the number of uninsured will also decline.

The number of uninsured increased each year from 1987 to 1998, even when the economy was booming. Small businesses accounted for many of the new jobs then, and such businesses are far less likely to provide insurance.

Health policy experts said the number of uninsured was likely to rise this year because the job market remains weak and many states have cut back their Medicaid programs. The unemployment rate was higher in 2002 than in 2001 and has climbed a bit further this year.