The common perception of an uninsured American has long been that of a low-wage worker unable to obtain employer-sponsored health coverage or a jobless person who must rely on hospital charity care when ill. And for good reason: The vast majority of uninsured citizens have always come from low-income families.

But the lack of health coverage is becoming a far more complex problem that cuts through socioeconomic strata. New census statistics show that the fastest-growing segment of the uninsured is, in fact, Americans from households with annual incomes of $50,000 or more.

Some experts have predicted that this would happen as employers cut health care costs and dropped workers from coverage. But now that it is a documented trend, it is placing a decidedly middle-class cast on the long-running but as yet inconclusive debate over how to expand health coverage -- and is prompting an election year reckoning for some in Congress....

"The unaffordability of health care insurance is coming to an employer near you," said Len Nichols, director of the health policy program at the nonpartisan New America Foundation. "The problem is not a lack of jobs per se, but rather that more and more workers are in jobs with wages too low to support rising health insurance premiums."

Nichols said the statistics bear out arguments for overhauling the traditional employer-based system and replacing it with a public-private system that includes government-sponsored insurance pools for those in need...

For the complete article, please visit the Congressional Quarterly website.