New figures on the uninsured are invigorating backers of a Bush administration plan aimed at providing employer-based health coverage to millions of small business workers.

A Census Bureau report released September 30, 2003, said that 2.4 million more people lost health insurance in 2002, pushing the number of uninsured to 43.6 million, an increase of 6% from 2001. Most lost coverage because of layoffs or because job benefits were cut.

Many employers who cut benefits are small businesses, and supporters of the White House measure say they want to bring health coverage within reach of millions of uninsured people by spreading the risk and reducing costs the way big companies and unions do.

"If we expect our small employers to provide health insurance, we must give them more and better options than they currently have," said Sen. Olympia Snowe, R-Maine, chairwoman of the Senate Small Business Committee.

Snowe and Missouri Republican senators Jim Talent and Kit Bond are sponsoring legislation that would allow small businesses to band together through national trade associations to offer insurance for employees.

"There's no reason to believe these new folks who are uninsured are any different from the folks who have always been uninsured," Talent said. "Most of these people are working people, and they're working for small businesses."

Six in 10 of the nation's uninsured work for small businesses or depend on someone who does, according to earlier Labor Department estimates.

More people lost insurance in Missouri, too, the Census Bureau said. The percentage of uninsured grew in Missouri from 9.9% in 2000-2001 to 10.9% in 2001-2002.

The health insurance bill cleared the House with bipartisan support but lacks Democratic backing in the Senate, where the two parties are split more evenly. It is controversial because it would waive standards mandated by state law by giving oversight of group health insurance plans to the federal government.

Many states insist on higher levels of coverage, including services such as mammograms, obstetrical care, mental health, mandatory appeals when claims are denied, and limits on how much older or sicker groups can be charged. Federal law does not make the same requirements.

The so-called association health plans "will place consumers at risk, as they are exempt from state patient protections and oversight," said Democratic Sen. John Kerry, an opponent of the measure who is campaigning for president. "The challenge is to help provide small businesses more leverage in the health insurance market while still preserving essential consumer protections," Kerry said.

Blue Cross, a major provider of coverage for small businesses, is leading the opposition to the bill. Foes also include most governors and state attorneys general, including Missouri Democratic Gov. Bob Holden and his fellow Democrat, Attorney General Jay Nixon.

"It would make the situation for small businesses much worse than it is today," said Alissa Fox, policy director for Blue Cross Blue Shield Association. "Association health plans will make uninsured numbers much worse."

There are long lists of allies on both sides of the issue. President Bush and the Department of Labor support the measure by the biggest small business industry group, the National Federation of Independent Businesses.

Rep. Sam Johnson, R-Texas, sponsored the measure in the House. "With costs spiking annually, there just are not enough affordable options," Johnson said.

Johnson had Democratic supporters in the House, but in the Senate, no Democrats have signed on.

"We are definitely going to let everybody know about these numbers, I can assure you of that," said Talent, who championed the idea as a House member and campaigned on it for Senate in 2002.

Talent said the new uninsured numbers should "continue to convince people that this problem is not going to get better on its own, and we need to do something." He said he hopes the Senate will vote on the measure in fall 2003 or early in 2004.