THE GROWING EPIDEMIC OF UNINSURANCE - NEW DATA ON THE HEALTH-INSURANCE COVERAGE OF AMERICANS

Despite a massive expansion of Medicaid and an upswing in the economy, the total number of Americans uninsured in 1993 was 39.7 million, mor e than at any time since the passage of Medicaid and Medicare in the 1 960s. Since 1989, the ranks of the uninsured have swelled by 6.3 milli on. Millions more would be uninsured if Medicaid enrollment had not ri sen dramatically, by 10.5 million people since 1989. Loss of health co verage is a growing problem for middle-income families, women, and chi ldren, as it has long been for low-income families. Even in Hawaii, wh ose employer mandate program is often cited as a model of universal co verage, there was a large increase in uninsurance. Nationwide, the sha rp upswing in the number of Americans who are uninsured has coincided with government and corporate policies to encourage medical competitio n and push people into managed care plans. Republican proposals to lim it AFDC benefits threaten to further increase uninsurance, particularl y among women and children. Only a Canadian-style single-payer reform can assure universal coverage and simultaneously contain costs.