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The number of Arizonans without health insurance shot up more than 40 percent from 2000 to last year, the Census Bureau says.

Local experts say they are skeptical that the ranks of the uninsured have grown that much.

But the U.S. Census Bureau's latest report on poverty, income and the uninsured shows more than 1.2 million Arizonans — or one in five residents — went without health insurance last year, up from 869,000 in 2000.

"That 40 percent figure just doesn't ring true," said John Rivers, president and CEO of the Arizona Hospital and Healthcare Association.

His group puts the number of Arizonans without health-care coverage at about 1 million. That would be about a 15 percent increase from five years ago.

"What we can say with confidence is our numbers of uninsured are increasing in Arizona just like they are everywhere else in the country," Rivers said. "That is a serious problem, and it cries out for solutions at the state and national level."

During the same period, 2000 to 2005, Arizona's overall population grew by about 20 percent.

More than 1 million Arizonans are covered by the state health plan known as the Arizona Health Care Cost Containment System, or AHCCCS.

Other options for people who qualify financially include the Pima Community Access Program, which entitles members to discounts from hospitals, doctors' offices, pharmacies and other care providers.

PCAP Executive Director Michal Goforth said she doubts that there has been a 40 percent increase in the number of uninsured Arizonans over the past five years. But she agreed with Rivers that the exact number is not the issue.

"That's really disappointing, considering how much people are doing to change that," Goforth said of the numbers.

Also skeptical was Steve Nash, executive director of the Pima County Medical Society.

The Census figures show, he said, "that we are slowly but surely eroding our work-based insurance in this country — that more and more employers aren't offering insurance, and if they do, they're not offering it to families and dependents but just their workers."

Nationwide, 46.6 million Americans are now without health coverage, the Census Bureau reported Tuesday. The new number represents an increase of about 16 percent from the 39.8 million Americans who had no insurance in 2000.

And despite state programs such as Arizona's KidsCare, children accounted for 8.3 million of the nation's uninsured, up from 7.9 million the year before.

The share of Americans who have no health-care coverage has increased every year for the last five years, a trend that policy experts expect will figure prominently in this fall's midterm election debates.

The Census Bureau also found that 12.6 percent of Americans were living in poverty last year, a figure unchanged from the year before. At the same time, median household income rose about 1 percent last year to $46,326 — half of households had less income than that, and half had more.

So why the growing numbers of uninsured?

"I think it's changing for a couple of reasons," Rivers said. "I think in our economy, both in Arizona and nationally, the shift is from a manufacturing-based economy to an economy based more on small, service-oriented businesses and other types of enterprises that typically do not offer health insurance.

"The manufacturing sector of our economy years ago led the way. But the auto and steel industries today are a fraction of the size they were 20 years ago.

"Our manufacturing base here in Arizona is declining as well," Rivers said. "It's the small service businesses that are tending to dominate our economy."

The cost of buying health insurance went up about 13 percent this year, according to industry reports. And as Rivers noted, employers who do offer coverage are requiring employees to pay a higher percentage of their costs.

"It's a problem that's getting worse," Rivers said, "and the public deserves a better system than the one we have today."

The hospital association has for years advocated a "universal" health-care system that would enable everyone to have at least basic health care, Rivers said. That does not mean the association advocates a "single-payer" plan, such as extending Medicare coverage to all Americans — a solution that appeals to groups such as Physicians for a National Health Plan.

Instead, what Goforth and others are working to provide are options that would help more people obtain at least basic care.

People who qualify for discounted care through the Pima Community Access Program pay a $40 annual membership fee. Their incomes must be between 100 percent and 250 percent of federal poverty level. That translates to a gross monthly income between $817 and $2,042 for a single individual, or between $1,667 and $4,167 for a family of four.

PCAP provides "gap coverage" for people who have too much income for AHCCCS but can't afford commercial insurance, Goforth said.

As the number of uninsured Arizonans has grown, so has the number on PCAP, she said. They now average up to 6,500 people a month, up from about 4,500 to 5,000 a month two years ago, she said.