RENEE MONTAGNE, host:
And as just we noted, the number of Americans without health insurance grew to an all-time high last year - 47 million people in all.
That's an increase of more than two million from the year before. The number of children without health coverage also rose, and those new Census Bureau numbers are likely to raise the stakes in the already heated political debate over what to do about health care.
Here's NPR's Julie Rovner.
JULIE ROVNER: Drew Altman of the Kaiser Family Foundation says the increase in the number of uninsured isn't that hard to explain. The average family's income is rising slowly, if at all, while the cost of their health insurance premiums at work is going up much faster.
Mr. DREW ALTMAN (Kaiser Family Foundation): What the numbers seem to be showing is the slow fraying of the employment-based system and overall, you know, the fundamental bedrock issue is just that health insurance is increasingly unaffordable, just not affordable for average working people.
ROVNER: As a result, more and more people with jobs are going without health insurance. Altman says the size of the increase in the uninsured is likely to have a major impact on the presidential campaign trail.
Mr. ALTMAN: These are very big numbers and you're going to start to see these numbers, these increases in the ranks of the uninsured appear in the speeches of virtually all of the candidates.
ROVNER: But the increase in the uninsured is likely to have a political impact on Capitol Hill as well. Congress and President Bush are currently at loggerheads over legislation to renew the state children's health insurance program known as S-chip. The program is set to expire at the end of next month.
Democrats and some Republicans in Congress want to expand S-chip. President Bush doesn't. Political scientist Jonathan Oberlander of the University of North Carolina says the spike in the number of uninsured children, 600,000 more last year, gives those who want to expand the program new ammunition.
Mr. JONATHAN OBERLANDER (University of North Carolina): I think this puts the Bush administration in a very difficult position of arguing against expanding S-chip. This is the second year in a row that the number of uninsured children has increased.
ROVNER: But supporters of a more market-based health system would prefer to help the uninsured by giving them tax breaks to buy their own private insurance.
Grace-Marie Turner heads the conservative Galen Institute.
Ms. GRACE-MARIE TURNER (Galen Institute): And that's really the public policy question. Do we want to put more and more people on taxpayer-supported coverage or do we want to move to a system in which people can have health insurance that they own and can keep with them as they move from job to job?
ROVNER: Meanwhile, political scientist Oberlander says he's not yet convinced the new census numbers will actually prompt the next president and the new Congress to fix the health insurance problem.
Mr. OBERLANDER: This adds fuel to the fire, but the fire's been burning for decades. And we have an amazing ability to walk over it.
ROVNER: In other words, all talk, no action, which is of course exactly what happened in the 1990s, the last time health care was a major issue in the presidential campaign.
Julie Rovner, NPR News, Washington.
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