Securing health care coverage for all Americans remains a central focus of the Foundation’s work, and for good reason. The latest figures from the U.S. Census Bureau show that nearly 44 million Americans, including 8.5 million children, are without health coverage. In 2002, the number of uninsured increased by more than 2 million, the largest one-year increase in a decade.

While the latest figures are grim, this year’s may be worse. Fast-rising health care costs continue to undermine the ability of working families, individuals, businesses and state governments to purchase health insurance. To make matters worse, severe budget constraints are causing states to curb spending on Medicaid and on programs that cover children from low-income families.

To reverse this disturbing trend, the Foundation is leading an unprecedented effort to highlight the challenges of the uninsured; foster a constructive, nonpartisan, national discussion on the uninsured informed by state-of-the-art research; and focus attention on a wide array of possible solutions.

The first Cover the Uninsured Week, co-chaired by former Presidents Gerald Ford and Jimmy Carter, brought home the message that millions of Americans—most of them from working families—struggle daily with serious threats to their health because they are uninsured. The campaign also underscored the immediacy of this issue, because virtually anyone can lose their health care coverage.

Between March 10 and 16, 2003, more than 800 national and local organizations and tens of thousands of Americans participated in nearly 900 public events—town hall meetings, interfaith prayer breakfasts, health fairs, business and labor events, and teach-ins at medical and nursing schools in all 50 states and the District of Columbia. These local events were coordinated with national and local advertising and the release of several new research studies.

In all, the Week’s events generated more than 3,000 news stories that reached a cumulative potential audience of 380 million. Most importantly, though, polling showed that the Week’s events contributed to a better understanding of the problem by a large number of Americans.

To effect positive social change, policy-makers need good information. The Foundation is committed to supporting analytically sound research. To that end, the Foundation asked the Lewin Group to produce estimates of the cost and coverage implications of 10 policy proposals to expand health care coverage. These proposals, developed by a diverse group of analysts from across the policy spectrum, ranged from individual tax credits to a publicly financed program of guaranteed universal coverage.

The estimates showed that significant progress can be achieved in covering the uninsured through a variety of approaches. National health spending would increase modestly, but the distribution of health care costs and savings among families, employers and government would shift significantly. This analysis was presented at a Capitol Hill briefing in October 2003 before an audience of congressional and executive branch staff and leaders of major national organizations.

Other Foundation-funded research on coverage released in 2003 included more than 50 reports from the Economic Research Initiative on the Uninsured at the University of Michigan, the Urban Institute and the Center for Studying Health System Change. These studies looked at why so many people are uninsured in America and what the lack of insurance means to them. The topics included the states’ fiscal crises; coverage of children in immigrant families; widowhood and divorce among mid-life women and their relationship to loss of health insurance; and unequal access to prescription drugs for African-American Medicare beneficiaries. In addition, the State Health Access Data Assistance Center at the University of Minnesota provided extensive technical assistance to states to help them produce estimates of the uninsured.