More than 2.2 million Arizonans — or 42 percent of the state’s non-Medicare population — went without health insurance at some point during the past year, according to a new study based on U.S. Census data.

Graphic: Uninsured in Arizona

Arizona ranked third nationally, behind Texas and New Mexico, in the percentage of people under 65 years old who were uninsured. Older Americans get health insurance through Medicare.

Nearly 80 percent lived in working families, and 70 percent of people without insurance were working full time, according to the study by Families USA, a Washington, D.C., health care advocacy group.

“Everyone is struggling with it. The system is broken,” said Sue Ringler, director of operations for Tempe Community Action Agency, which among other things runs two health clinics in cooperation with Arizona State University’s College of Nursing.

“It’s bad out there,” she said. “It’s bad out there for low-income folks. It’s bad out there for regular folks like me.”

The study’s findings differ dramatically from recently released census data showing about 16 percent of Americans were without health care coverage.

Researchers, working with the Lewin Group, included people who were uninsured for as little as one month during the past year. The census estimate is based on an entire calendar year, so it doesn’t count those who might have been uninsured for 10 out of 12 months.

The Families USA report showed that the number of Arizonans without health coverage has increased from 1.6 million seven years ago, or 37 percent of the nonelderly population.

Local and national experts say several factors are combining to raise the ranks of the uninsured.

In Arizona, a proliferation of low-wage, part-time and seasonal jobs, together with a relatively small number of large employers, mean fewer and fewer businesses are offering health care coverage.

And if they do offer it, they’ve increased premiums and co-pays, causing some employees to opt out.

Since 2000, employees’ share of family premiums increased by 78 percent, according to Families USA.

Also, eligibility for Arizona’s safety nets of publicly funded health insurance — the Arizona Health Care Cost Containment System and KidsCare — is set lower than some other states, making it harder for the working poor to qualify.

“This is a state that has decided that health care is much more of a privilege than a right,” said Eugene Schneller, professor of health administration and policy at Arizona State University.

“It’s also a state that has not made some of the really tough decisions to make sure that everybody has access to care,” Schneller said.

Studies have shown people without health insurance are more likely to let little medical problems become big ones, then get treatment from hospital emergency departments.

They forego preventive care and health screenings, and are more likely to be sicker and die earlier.

And a growing number are going broke when hit hard with health care bills.

Even nonprofit community agencies aren’t immune from the health insurance squeeze.

Ringler pays more than $500 a month to include her husband on her insurance plan. She’s grateful to have the coverage, though, in light of his triple bypass surgery last spring.

“If I didn’t have insurance,” she said, “we would’ve probably been bankrupt.”

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