Senator Eliot Shapleigh - El Paso, Texas

WASHINGTON — As the Obama administration scrambles to maintain support, in the face of record federal deficits, for a health care overhaul this year, a study to be released today says American workers are at significantly higher risk of being uninsured than they were in the 1990s, the last time lawmakers tried to revamp the system.

A 2006-07 study for the Robert Wood Johnson Foundation, a health-related philanthropy group, found nearly 1 in 5 workers was uninsured, up from fewer than 1 in 7 during the mid-1990s.

In Texas, 28 percent of workers lacked health coverage in 2006-07, the study found. That is an increase from 24.2 percent uninsured in 1994-95. Texas tied New Mexico for the largest percentage of uninsured workers in the study.

"We're kind of a poster child for what happens when work doesn't deliver access to health care," said Anne Dunkelberg, the associate director of the Center for Public Policy Priorities, which is an advocate for low- and moderate-income families.

That lack of coverage ultimately affects Texas taxpayers because hospitals spend billions on care for the uninsured, Dunkelberg said.

Lynn Blewett, director of the State Health Access Data Assistance Center at the University of Minnesota, which conducted the research, said, "The thing I think is interesting is how many workers are newly uninsured."

"In the last couple of years we've seen a deterioration of private health insurance," Blewett said.

The problem is cost. Total premiums for employer-sponsored plans have risen six to eight times faster than wages, depending on whether individual or family coverage is picked, the study found.

About 20.7 million workers were uninsured in the mid-1990s. A decade later, it was 26.9 million, an increase of about 6 million, the study found.

In the 1990s, there were eight states with 20 percent or more of the working age population uninsured. Now, there are 14: Alaska, Arizona, Arkansas, California, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina and Texas.

Yet workers continue to pay the bill for covering others. Their payroll taxes help support Medicare, which covers the elderly. Income taxes and other federal and state levies pay for covering the poor and the children of low-income working parents. But government provides little direct assistance to help cover workers themselves.

A program like President Barack Obama's proposal, which would commit the nation to coverage for all, is estimated to cost about $1.5 trillion over 10 years. Yet the U.S. health care system, already the world's costliest, is also considered one of the most wasteful.

"I don't think we can delay action beyond this year," said Dr. Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation. "It's clear that we are at the brink."

For the Ramer family of Denver, Iowa, it's already too late. Husband Jim, a truck driver for a road-building company, died of a heart attack in 2005 at the age of 59.

His wife, Cindy, 58, is a certified nursing assistant who works at a nursing home that canceled medical coverage for employees several years ago because it had become too expensive. She hasn't had a regular checkup in about three years.

"I don't think it's fair that I'm caring for people and helping them with their health care, and I don't have adequate, affordable health care of my own," she said.

"I'm not asking for a handout. I'm just asking for something I can afford," Ramer said.