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Health insurance falling short

A spike in the number of 'underinsured' adults since 2003 startles healthcare experts.

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The economic downturn is speeding up the unraveling of America's healthcare system.

In what experts call a "startling" development, the number of people who have health insurance but not enough to pay their medical costs has spiked from 16 million in 2003 to 25 million in 2007, according to a new analysis.

They're called the underinsured – working Americans whose employers don't provide health insurance so they have to buy it on their own, or who have jobs that offer only catastrophic plans with high copayments and deductibles in the thousands of dollars. An increasing number are solidly middle-class.

The study by nonprofit, nonpartisan Commonwealth Fund also found that underinsured Americans are now acting more like the nation's 47 million uninsured: They're more likely to forgo recommended medical care for fear they won't be able to pay for it. Such preventive intervention is key to keeping healthcare costs down, medical experts say.

A total of 75 million working adults were either uninsured or underinsured in 2007, the study found. That's 42 percent of the US population ages 19 through 64, up sharply from one-third in 2003.

"This erosion in insurance protection is putting patients, families, and the nation's health and economic security at risk," says Cathy Schoen, senior vice president of the Commonwealth Fund and one of the study's coauthors. "As a nation we are losing ground. We need to move in new directions."

With the faltering economy and the war in Iraq dominating the presidential election, healthcare reform ranks third in Americans' top concerns, according to recent polls by the Los Angeles Times and Bloomberg News. With the increase in the uninsured and underinsured populations, and with premiums and deductibles rising, many healthcare experts expect that Congress will face greater pressure to act on health reform.

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