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The percentage of people covered by employer health insurance plans dropped to 59.7 percent in 2006, from 60.2 percent in 2005.

There was no change in the number of people covered by Medicaid, the federal insurance program for low-income people -- 38.3 million.

Uninsured rates for whites remained constant at 10.8 percent but rose among blacks -- from 19 percent in 2005 to 20.5 percent in 2006. The percentage and the number of uninsured Hispanics increased to 34.1 percent and 15.3 million in 2006.

Commenting on the report, Karen Davis, president of the Commonwealth Fund, said the increase in the number of uninsured Americans was surprising, given the relatively low unemployment rates and a stable economy. She said she fears a dramatic increase in the number of people without health insurance should the economy weaken.

"It's a surprising jump in the numbers of uninsured," Davis said. "To get a 2.2 million hike in one year is pretty disturbing. We are getting a middle-class squeeze -- it's not just families in poverty."

Davis added that employers were dropping coverage of dependents. "It really varies by the income of the family," she said. "Either employers aren't covering the kids, or the premium share is too high for families to afford."

There is urgency in getting people -- especially children -- covered, Davis added. "We need to get more comprehensive solutions on the table," she said. "There is a case for action to deal with uninsured children, and we need a comprehensive strategy that insures health insurance for all."

Kathleen Stoll, director of health policy at the consumer advocacy group Families USA, also expressed shocked at the rise in the number of uninsured Americans.

"The numbers took my breath away," Stoll said. "The increase is more dramatic than we've seen."

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