Across the nation, families face the future with growing concern. Affording ballooning home payments, providing an education for their children and even putting gas in the car or oil in the furnace at home have become ever greater challenges as prices soar and wages stagnate.

But nowhere is the challenge greater than in healthcare. Since the year President Bush took office, health insurance costs have risen four times faster than wages.

Employer after employer has either dropped coverage completely, or required workers to devote more and more of their paycheck to premiums, co-pays, and deductibles. As the nation heads into a possible recession, the number of Americans who cannot afford healthcare will soar ever higher.

Most at risk are those who are most in need.  Workers displaced from their jobs by the economic downturn may well lose health insurance coverage — a loss that brings with it the constant fear that a child’s cough may signal the start of a serious infection, or that every ache and pain is a sign of major illness. Families who receive quality healthcare through Medicaid are at risk of losing that coverage, too, as states try to close gaping budget shortfalls by dropping families from their rolls.

We know all too well the consequences of losing health insurance coverage. Those without insurance are more likely to delay seeking needed treatment until their illness becomes so acute that it forces them to the emergency department. By then, the damage may be too severe to be repaired.

The tragedy is that inadequate coverage too often means that a worker who once sought new training or a return to the job instead becomes a patient unable to provide for their family. Individuals who experience major health challenges are 15 percent less likely to return to the workforce than those who stay healthy, according to a report prepared by the RAND Corporation.

The toll of our inadequate and unaffordable healthcare system on our economic productivity is vast. The Institute of Medicine estimates that we as a nation pay an additional $130 billion every year due to the cost of preventable illness among the uninsured. The Commonwealth Foundation estimates the total cost of lost productivity due to ill health among all American workers is higher still — over $250 billion every single year.

But the greatest impact of lost health coverage is felt by individual families. Half of uninsured adults have problems paying medical bills, and 27 percent of those who are uninsured have to change their way of life to pay medical bills.

Three-quarters (76 percent) of those are forced to change their standard of living by drawing down savings or stinting on basic needs such as food, rent or heating bills. The nation cannot recover economically if millions of working families are pushed to the brink by soaring health costs.

Fueling America’s economic recovery demands immediate and comprehensive action. Strengthening unemployment insurance, investing in our workers and helping those in need meet the rising cost of basic necessities must all be part of our proposal.

But a comprehensive response requires that America invest in the health of our people so that they can invest themselves in the health of our economy.

I propose two simple ways to help Americans stay in work or get back on the job when they have been laid off.

First, we must help those who have lost their jobs afford healthcare, either by aiding them in maintaining the coverage their employers formerly provided or through assistance in affording coverage from other sources.

Second, we must prevent low-income families from falling through the cracks that inevitably open up when states balance budgets in hard times through severe cuts to Medicaid. The means to do so is simple and proven to be successful.

In 2003, Congress enacted a temporary increase in the federal matching rate for Medicaid.

The effect was immediate and positive. States that had been planning to drop low-income families from the Medicaid rolls reversed their decisions, allowing families across America to keep the coverage that kept them healthy and productive.  

We should implement this successful measure once again. This increase should not be unrestricted, but should instead come with stringent requirements that states not enact further curbs on enrollment or coverage and must utilize the funding solely for Medicaid.

 These simple proposals — aid for those who have lost their jobs and an incentive for states to continue to cover low-income families — meet the critical test for an effective stimulus.  They are timely, temporary and targeted to those who need them the most. Tax cuts for the affluent meet none of these tests. They are slow to take effect, permanent in duration and are targeted to the wealthy and most privileged.

Improving the healthcare of our workforce and their families ought to be a foundation of any effective stimulus for our economy. A healthy workforce is a productive workforce, and America cannot afford to have its most productive workers sidelined through ill health.

Kennedy is a member of the Senate Health, Education, Labor and Pensions Committee.