Census: Less Workers Have Health Cover

"That was the principal cause of the overall decrease in health insurance coverage," according to the report.

"This new number means that there are more uninsured people than the aggregate population of 23 states plus the District of Columbia," said Ron Pollack, executive director of Families USA, a Washington-based consumer's organization.

The only silver lining in the Census Bureau's report, he said, is that public programs such as Medicaid covered more people last year and cushioned the loss of coverage in the private sector.

"This demonstrates that public program expansions should be enacted to increase health coverage for low-wage working adults," Mr. Pollack said.

Donald Young, president of the Washington-based Health Insurance Association of America, said, however, that the jump in the number of uninsured Americans should raise a warning flag to federal and state lawmakers.

He noted that the decrease in the number of people with employer-sponsored coverage occurred entirely among small firms with fewer than 25 employees.

These employers, Mr. Young said, are the most vulnerable to economic downturns and rising prices.

"Legislators should think very carefully about establishing new regulations and mandates that, no matter how well-intentioned, inevitably raise the cost of health insurance and make it more difficult for employers to continue to provide this vital benefit, and for employees to be able to afford it," he said.

Legislators, Mr. Young said, should work to create an environment that brings affordable health insurance within the reach of millions of additional citizens.

According to the Census Bureau, the proportion of people who had employment-based policies fell for workers employed by firms with fewer than 25 employees, but was unchanged for those employed by larger firms.

The number and percentage of people covered by government health insurance programs rose significantly, the Bureau added.

In particular, some 31.6 million people, or 11.2 percent of the population, were covered by Medicaid during 2001. This compares with 29.5 million, or 10.6 percent of the population, in 2000.

The Bureau said that young adults, those between 18 and 24 years old, were the least likely age group to have health insurance in 2001. Some 28 percent of 18-to-24-year-olds were uninsured, the Bureau said.