47 million Americans are uninsured
11.7 % Census data fuel attacks by Democrats
By John Donnelly, Globe Staff  |  August 29, 2007

WASHINGTON -- A record 47 million Americans did not have health insurance last year, while the percentage of children without insurance rose for a second consecutive year, according to US Census Bureau data released yesterday, leading Democrats to charge that the Bush administration has ignored a growing, more vulnerable population.

The census data found that, compared with 2005, the number of uninsured Americans rose 5 percent last year to 47 million, due in large part to cutbacks in employer-sponsored health coverage. It also found that 11.7 percent of US children under 18 lacked health insurance, compared with 10.9 percent in 2005.

An estimated 10.3 percent of children in Massachusetts went without health insurance from 2004 to 2006, slightly below the national average.

Nationally, the percentage of uninsured children had fallen over a five-year period beginning in 1999 because of the expansion of Medicaid and the State Children's Health Insurance Program, or SCHIP. Medicaid generally covers people living below the official income poverty line, set at $20,650 for a family of four.

But in the last two years, according to analysts, those two safety net programs could not keep up with the steady national decline of private, employer- provided healthcare plans. In 2000, nearly 66 percent of children nationwide were covered by those programs, compared with fewer than 60 percent last year, according to census figures.

The census data showed that 8.7 million American children were uninsured last year -- 1 million more than in 2004, according to the data.

"For many years, Medicaid and SCHIP were growing at a fast enough rate to more than offset the falling numbers of people on employee-sponsored healthcare, but not in the last two years," said Leighton Ku, a senior fellow at the Center on Budget and Policy Priorities, a left-leaning think tank based in Washington. "They failed to provide the same effectiveness in protecting children's health insurance."

The new data are expected to become part of an already contentious debate in Washington between the White House and the Democratic majority in Congress over legislation that calls for a significant increase in the SCHIP program. President Bush has threatened to veto any major expansion of the program, based on the principle that the federal government should not be funding insurance for those whose incomes could be considered middle-class.

Earlier this month, the Bush administration increased its efforts to rein in the SCHIP proposal to focus only on the neediest children. It sent a letter to state health authorities saying that states would have to demonstrate that 95 percent of the children from families earning less than 200 percent of the poverty level were served by Medicaid or SCHIP. Only then, the administration said, could states expand the program to families with incomes greater than 250 percent of the poverty level, or $51,625 for a family of four.

That directive from the administration could hurt many states, including Massachusetts, which under its healthcare reform program increased eligibility to families earning 300 percent of the poverty level, or $61,950 annually for a family of four. Federal officials approved the change last year, which allowed Massachusetts to enroll 14,000 more children.

Under the more generous House bill, the program would give states the flexibility to cover children from families who earn less than 400 percent of the poverty rate, which would be $82,600 for a family of four. In 2006, 91 percent of the children covered under SCHIP were from families with incomes of $41,300 for a family of four.

The Senate bill, by contrast, would cap eligibility of children whose families earn $61,950. Backers of both versions of the legislation estimate that their bills would cover an additional 3 million to 4 million children.

Democrats immediately cited the census study as evidence that more families need SCHIP.

"Today's news serves as even more evidence that programs like SCHIP must be fully funded and extended to the growing numbers of uninsured Americans," said Senator John F. Kerry of Massachusetts. "Healthcare costs are soaring, and our healthcare professionals are feeling incredible burdens."

Senator Hillary Clinton of New York, who is running for president, likened the study to her attempts to reform healthcare during her husband's first term.

"When I began the fight for universal coverage almost 15 years ago, there were 37 million people uninsured," Clinton said in a statement yesterday. "It was an outrage then and with 10 million more people uninsured today, it is an even deeper outrage today. Yet, the uninsured have been invisible to this president."

Despite the rise in the numbers of uninsured, the census figures found that the percentage of those classified as poor fell to 12.3 percent, from 12.6 percent in 2005, the first significant decline since 2001. Median household income rose nearly 1 percent to $48,200, still less than its peak in 1999.