WASHINGTON (AP) -- Cindy Ramer works full-time nursing the mentally disabled, making sure their medical needs are met.
But the 58-year-old widow hasn't had a doctor's checkup in more than three years, ever since the nursing home where she works decided it could no longer afford to offer medical insurance to its employees.
"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," said Ramer, of Denver, Iowa.
American workers -- whose taxes pay for massive government health programs -- are getting squeezed like no other group by private health insurance premiums that are rising much faster than their wages.
While just about all retirees are covered, and nearly 90 percent of children have health insurance, workers now are at significantly higher risk of being uninsured than in the 1990s, the last time lawmakers attempted a health care overhaul, according to a study to be released Tuesday.
The study for the Robert Wood Johnson Foundation found that nearly 1 in 5 workers is uninsured, a significant increase from fewer than 1 in 7 during the mid-1990s.
The problem is cost. Total premiums for employer plans have risen six to eight times faster than wages, depending on whether individual or family coverage is picked, the study found.
"The thing I think is interesting is how many workers are newly uninsured," said Lynn Blewett, director of the State Health Access Data Assistance Center at the University of Minnesota, which conducted the research. "In the last couple of years we've seen a deterioration of private health insurance."
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.
"There really aren't safety-net programs for adults," Blewett said.
The study comes as the Obama administration is scrambling to maintain support for a health care overhaul this year in the face of record federal deficits. A program like President Barack Obama's, 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, which provides extensive financing for health care research. "It's clear that we are at the brink."
For the Ramer family, 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. He was uninsured and trying to cope with diabetes, a chronic disease that requires prescription drugs and follow-up medical care to control.
His widow, Cindy, 58, is a certified nursing assistant who lost her health care benefits three years ago. Now, instead of regular doctor checkups, she goes to health fairs for bone-density measurements and other screening tests.
"I'm not asking for a handout. I'm just asking for something I can afford, and won't have all these restrictions that they'll cover this and won't cover that." Ramer says she can afford to pay about $100 to $150 a month.
If anything, the situation for workers appears to be worse than is reflected in the report. It analyzed census data through 2007, the latest year available. But that was before the economy tumbled into recession.