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A startling new report from The Commonwealth Fund, "Gaps in Health Insurance: An All-American Problem," reports that one in five working age adults is paying off medical debt, that nearly 60 percent of uninsured adults skip medication because they can't afford it, and many are ending up in emergency rooms and require hospitalization.

Forty one percent (that's two out of five) working-age Americans whose incomes are between $20,000 and $40,000 were uninsured for at least a portion of the past year. Working families constitute the vast majority of the uninsured. There was an estimated 48 million working-age Americans uninsured during the year—67 percent of that number was families in which at least one person was working full time. Here are some other findings:

• More than 44 percent of all working-age adults with medical debt reported that it was $2,000 or more.
• More than 82 percent of uninsured adults had been without insurance for one year or more.
• Sixty-three percent were solo business owners or working for firms with fewer than 100 employees.
• 51 percent of uninsured adults reported medical debt or bill problems. Of those, nearly half (49 percent) used up all their savings to pay their bill, and two of five were unable to pay for basic necessities.
• Just 41 percent of uninsured adults had a regular doctor or other health-care professional compared with 86 percent of insured adults.
With soaring food prices and gasoline averaging well above $4 a gallon, more and more people are likely to find they can't afford health insurance.