PRINCETON, NJ – Without significant reform to the healthcare system, the number of uninsured Americans could grow by 10 million in five years, according to the Robert Wood Johnson Foundation.

A RWJF report projects that by 2015, there could be as many as 59.7 million people uninsured, and that number could swell to 67.6 million by 2020. An estimated 49.4 million individuals were without health coverage in 2010.

The report also shows that spending on government healthcare programs for the poor could more than double by 2020.

Analysts at the Urban Institute used a Health Insurance Policy Simulation Model to assess the changes in coverage patterns and healthcare costs that will occur nationally from 2010 to 2020 if major reforms aren't enacted.

The study examined worst-, intermediate- and best-case scenarios.

The analysis shows that the middle class would suffer most without reform. For employers who continue to offer health insurance benefits, an increasing amount of the cost would likely be passed on to workers. At the same time, individuals and families would face higher out-of-pocket costs for premiums and healthcare services.

“Families and individuals across this country are already stretched beyond their means. They simply cannot afford to see their insurance costs rise by more than a third in just five short years,” said Risa Lavizzo-Mourey, MD, the RWJF's president and CEO. “This report paints a grim picture for the future of our nation if we fail to make health insurance more affordable for all Americans, while also reducing healthcare costs.”

The Urban Institute model shows that under the worst-case scenario, if healthcare reform is not enacted:

• Individual and family spending on premiums and out-of-pocket healthcare costs would increase significantly.
• Spending would jump 34 percent by 2015 and 79 percent by 2020.
• The uninsured rate for middle-class families earning 200 percent to 399 percent of the federal poverty level (FPL) – roughly $40,000 to $75,000 a year – would rise by 9 percent, from 19 percent to 28 percent. Overall, the share of the uninsured from all families with incomes higher than about $40,000 would rise from 44 percent to 53 percent in 2020.
• The uninsured rate for adults ages 45 to 54 would increase from 17 percent in 2010 to 24 percent in 2020. For adults ages 55 to 64, the uninsured rate would increase from 15 percent in 2010 to 22 percent in 2020.
• Premiums for both single and family policies would more than double by 2020, increasing from $4,800 to $10,300 for single policies and from $12,100 to $25,600 for family policies.
• Employer spending on premiums, despite the fact that fewer people would be covered through their employer, would increase from $430 billion in 2010 to $851 billion in 2020.

“By examining the best available economic data, we can project what will happen to our healthcare system if we continue along our current path,” said lead author Bowen Garrett, PhD., a senior research associate in the Health Policy Center at the Urban Institute. “The bottom line is that we are likely to see a significant deterioration in who has health insurance coverage in this country, coupled with untenable increases in private and public spending.”