Bloomberg, August 29, 2006


[Rachel's introduction: "The number of Americans without health insurance probably rose to a record in 2005 as medical costs increased three times as fast as wages, according to forecasts for a Census Bureau report today."]

By Matthew Benjamin and Kerry Young

The number of Americans without health insurance probably rose to a record in 2005 as medical costs increased three times as fast as wages, according to forecasts for a Census Bureau report today.

The total has climbed every year since President George W. Bush took office, a point Democrats are likely to seize on in this year's congressional election. In February Bush called the 45.8 million who didn't have insurance in 2004 "unacceptable in our country." Emory University Professor Ken Thorpe in Atlanta says Bush has done little to help these people.

"We've had absolutely no federal effort or interest in insuring the uninsured since 2000," said Thorpe, who was deputy assistant secretary for policy at the Department of Health and Human Services from 1993 to 1995. "This has not been a priority of the Bush administration."

The government also will probably report that the percentage of Americans living in poverty dropped after reaching a six-year high in 2004, said Bob Greenstein, executive director of the Center for Budget and Policy Priorities in Washington.

Median household income probably rose from 2004's $44,389, Greenstein said. The news on income and poverty reflects economic growth, economists say. The US economy expanded 3.2 percent and added 2 million jobs in 2005.

"Every year as you move away from a recession, you expect the growth of the poverty rate to slow and eventually reverse," says Austin Nichols, an expert on child poverty at the Urban Institute in Washington.

Hubbard's Challenge

Al Hubbard, Bush's top economic adviser, in March called misleading the Census Bureau's 2004 estimate of the number of people without insurance. Of the almost 46 million, about 8 million don't have access to insurance, he said, while 15 million others would qualify for the state-federal Medicaid insurance program for the poor, and others are illegal immigrants.

Without having seen the 2005 numbers, Hubbard stands by his statement on the 2004 figures, White House spokeswoman Emily Lawrimore said yesterday.

Harvard University researcher Robert Blendon and Uwe Reinhardt, a professor of health economics at Princeton University, said the number of people without health insurance probably rose. The 2004 total was almost one in six Americans. Surging costs are keeping the number from falling as the economy expands, health-policy researchers say.

The average expense of providing medical care for a family of four rose 9.6 percent to $13,382 this year, according to a survey by the Seattle-based Milliman consulting group. The cost of insurance bought through an employer increased 9.2 percent in 2005, according to the Henry J. Kaiser Family Foundation in Menlo Park, California, as average hourly earnings climbed 3.2 percent.

"Due to the rising cost of health care and health-care insurance, you see a continued decline in workers accepting coverage when it's offered and employers offering it," Emory's Thorpe says.

Health Savings Accounts

Bush's attempt to expand coverage through tax-advantaged health- savings accounts helped the middle class more than the poor, researchers say. The number of uninsured Americans fell by 5.6 million during the final two years of the Clinton administration to 38.7 million in 2000.

"The media and Democrats are waiting for this kind of information, and they'll use it" in the elections, says David Mayhew, a congressional scholar at Yale University in New Haven, Connecticut.

The Republicans now hold 231 seats in the House of Representatives, where all 435 seats are up for election this year. Republicans have 55 seats in the Senate, where a third of the 100 seats are being contested.

Massachusetts Plan

Frustrated by the lack of federal leadership on health care, states have jumped ahead and moved toward making sure all citizens have health insurance, said Marty Sellers, a Philadelphia-based consultant who advised Massachusetts Governor Mitt Romney in designing his state's program.

Massachusetts passed the nation's first law requiring all adults to have health insurance by July 1, 2007. Vermont, Illinois and Rhode Island are considering similar plans.

The fight to get more Americans insured this year united the US Chamber of Commerce, representing 3 million businesses, with some of the biggest unions, the AFL-CIO and the Service Employees International Union. The organizations joined the American Medical Association and dozens of religious and nonprofit groups in a May "Cover the Uninsured Week" campaign.

Susan Squire of Warren, Michigan, was among the thousands of people who participated in events staged across the US. Squire filed for bankruptcy in October because of $91,000 in medical bills from a January 2005 heart attack and subsequent surgery.

"Daily Threats"

"I paid some off. I paid some down. I was trying to pay them off one by one," Squire said in an interview. "Some went along with me, but the bulk of them did not. They started with the daily calls, the daily notices, the daily threats."

Squire, who was making about $21,000 a year with part-time bookkeeping work, has less clout to negotiate discounts as an individual. More than half of Americans get medical coverage through plans bought by employers, which contract with insurance companies to work out prices with hospitals and doctors.