More Uninsured At Big Firms

(CBS/AP)  A third of the nation's workers without health insurance are employed by large companies, a study says.

Thirty-two percent of all uninsured workers in 2001 were employed by big companies, up from 25 percent in 1987, according to the report released Tuesday by The Commonwealth Fund.

Researchers cited as factors soaring health care costs, declines in manufacturing and union jobs and the changing structure of large corporations — those with more than 500 employees — and the benefits they offer.

"Policy-makers seeking solutions to the growing uninsured problem must look beyond workers in small firms, or they risk leaving out a large group of low-wage uninsured workers," said Jeanne Lambrew, an author of the study and an associate professor of health policy at George Washington University.

The study also noted that seven out of 10 uninsured workers at large companies were not offered health insurance, and 15 percent were ineligible. Low-income workers were the most likely to be without coverage.

The Census Bureau estimates that 44 million Americans were uninsured last year.

While researchers found a growing number of uninsured workers at large firms, they said the opposite was true for small and medium-sized companies.

The percentage of uninsured employees in small businesses — those with fewer than 100 workers — dropped from 67 percent in 1987 to 57 percent in 2001. Similarly, the number of uninsured workers at medium-sized companies fell from 14 percent to 12 percent during the same period.

Access to health care and employers' rising costs have been debated in Congress and by the nine Democrats seeking to challenge President Bush next year. The issue also is at the center of numerous labor disputes in California and elsewhere.

Striking grocery workers and public transit mechanics have caused widespread inconvenience and economic losses in Southern California. Thousands of Kroger Co. grocery workers also walked out in West Virginia, Ohio, Kentucky and Missouri last week.

Unions are fighting to retain top-of-the-line medical benefits while employers want workers to pick up more of the cost.

Other recent health care news has told a similar story of rising cost and reduced coverage:

Medicare premiums will rise next year by 13.5 percent to $66.60 a month for about 40 million Americans in the program, the third-largest increase in its history, the government said last week.

Health insurance costs continued to escalate at a double-digit pace in 2003, but a study by Hewitt Associates finds indications that rates may begin leveling off as early as next year. For 2004, the Illinois consulting firm is projecting a 12.6 percent average increase for employers, which is lower than 2003's 14.7 percent rate. Still, that's about $1,000 more for each worker.

Health care premiums for families in employer-sponsored plans soared 13.9 percent in 2003, the third year of double-digit growth and the biggest spike since 1990, a recent study found. Annual family premiums increased to $9,068 this spring, according to a survey of 2,808 companies by the Kaiser Family Foundation and the Health Research and Educational Trust, each a health research organization.

An additional 2.4 million people fell into the ranks of the uninsured last year, according to Census Bureau estimates that show a second consecutive annual increase spurred by people losing coverage when they are laid off or their job benefits are cut.