US study finds rise in state's uninsured

The number of Massachusetts residents without health insurance jumped about 10 percent last year, surpassing the growth in the uninsured nationally and raising concerns whether climbing private health insurance premiums are shutting out middle-income workers.

The federal Census Bureau reported yesterday that the number of uninsured residents in Massachusetts grew to 748,000 last year, up by 66,000 people from 2003. Massachusetts healthcare organizations and the state have estimated a smaller number of uninsured -- between 460,000 and 532,000 residents last year.

But consumer advocates and Governor Mitt Romney's administration said that the underlying trend in the Census Bureau's figures is probably accurate.

''It's a huge increase and unfortunately it's not a surprise," said John McDonough, executive director of a Boston-based advocacy group, Health Care for All. ''It's all tied to the cost of health insurance. It's either employers dropping coverage, which we haven't seen much of, or employers raising the cost of coverage to workers, so they can no longer afford it."

The state, which surveys residents about healthcare issues every other year, found that the number of uninsured jumped 10 percent to 460,000 last year, from 418,000 in 2002. The census numbers are higher because the federal government does not fully count the number of residents who do not have private insurance through work but are enrolled in Medicaid, the state and federal health insurance program for the poor, state officials and advocates said.

Tim Murphy, secretary of the Executive Office of Health and Human Services, said the federal report provides further evidence of the need for healthcare reform.

''This is something that has been of concern to the administration, and is the reason the governor put forth a plan," the Romney Cabinet official said. ''We realize small businesses are having more and more trouble absorbing the double-digit premium increases each year."

Romney has made a plan to cover the state's uninsured a major part of his legislative agenda. His proposal includes an ''individual mandate," which would require residents who do not qualify for state programs to obtain insurance or face tax penalties and even the garnishing of their wages.

McDonough is part of a large coalition of groups pushing for a different healthcare plan that would require most employers to cover their workers.

According to the Census Bureau, 11.7 percent of the state's 6.4 million residents lacked health insurance last year, up from 10.7 percent in 2003. It is a lower percentage than for the country as a whole, where 15.7 percent of Americans did not have health insurance last year. But the national percentage has remained steady the last two years.

From 2001 to 2004, according to the Census Bureau, the number of uninsured Massachusetts residents soared 44 percent; the biggest jump came in 2002, when the increase was 24 percent.

''Although Massachusetts has historically been a leader in protecting access to healthcare, the recent trend has been in the wrong direction. Without state action to address the problem, more and more people in Massachusetts may find themselves unable to secure health insurance for their families," Noah Berger, executive director of the Massachusetts Budget and Policy Center, said in a statement. The nonprofit group analyzes the impact of state policies on the poor and middle-class.

The Census Bureau found that for 2003-2004, the poverty rate in Massachusetts was 9.7 percent, almost unchanged from the 2002-2003 rate of 10.1 percent. In constant 2004 dollars, median household income in Massachusetts was $52,347 for the 2003-2004 period, nearly the same as for the 2002-2003 period, when it was $52,346.

The national poverty rate was 12.7 percent in 2004, almost unchanged from the previous year's figure of 12.5.

In Washington, analysts disagreed on what the Census Bureau figures show about the economy.

Kathleen Cooper, a former Bush administration official who oversaw the Census Bureau until her recent retirement, said the overall results are encouraging.

Speaking on a panel yesterday, Cooper said that the 2004 poverty rate ''is still lower than all but one year in the 1980s and 1990s."

But others were troubled that Medicaid programs are covering more Americans because employers are providing less health insurance coverage.

''The new data are particularly troubling for working people, showing backward movement for most workers," Robert Greenstein, executive director of the Center on Budget and Policy Priorities, a nonprofit research organization in Washington, said in a telephone conference call yesterday with reporters. ''In short, the census data provide new evidence that, as in 2002 and 2003, the recovery was neither robust nor broad-based."

Globe correspondent Kaitlin Bell contributed to this story