In the individual insurance market, premiums are, on average, even less affordable. Due to the underwriting practices in some states, many individuals, particularly those who are older or have chronic health problems, are left on the sidelines—unable to even qualify for coverage. 3 As health care costs have climbed, so has the number of people without health insurance in the United States, even during a period of overall economic growth. In 2004, according to . Census data, nearly 46 million people of all ages were uninsured, an increase of 6 million over 2000. 4 This combination of eroding health insurance coverage and.