The report, released by the Commonwealth Fund, found 19 million full-time workers and dependents in 2004 were uninsured and 11 million members of working families were on public healthcare programs such as Medicaid compared to 16 million in 1999.

The report, prepared by Sherry Glied and Bisundev Mahato of Columbia University in New York, found federal, state and local governments pay $33 billion a year for public coverage such as Medicaid and the State Children's Health Insurance Program for full-time workers and family and $12 billion in uncompensated care expenses.

In 2004, about 3 million workers in large firms were enrolled in public heath insurance, more than double the 1.4 million enrolled in 1999, the report said. However, workers without coverage from their employers are disproportionately concentrated in smaller firms.

The cost borne by the public for full-time workers not covered by their own employers is largely a result of fewer workers and worker family members obtaining health insurance coverage through their employers -- even among those employed by firms with more than 100 employees.