The number of Washingtonians with no health insurance has reached 1 million, according to a new report from state Insurance Commissioner Mike Kreidler. About 14.5 percent now have no coverage at all.

“This is a grim milestone for the state, and we believe the situation will remain bleak for two more years,” said Kreidler. “But it’s important for people to know that there is hope is on the horizon.”

Among the report’s findings: From 2008 through 2010, the number of uninsured people in Washington grew by 180,000; charity care by hospitals and health care providers rose a staggering 36 percent; and the percentage of residents without health coverage worsened in 31 of 39 counties; in several counties, more than 1 in 5 residents has no health coverage.

Counties with a particularly high percentage of uninsured residents include: Adams, Grant, Okanogan, Franklin and Yakima. But the problem also worsened in King, Pierce, Snohomish and Spokane counties.

In 2008, 81,421 of 805,400 Pierce County residents, or 10.3 percent, were uninsured. In 2010, 104,659 of 795,225 Pierce County residents, or 13.2 percent, were uninsured. Uncompensated health care costs in Pierce County totalled $72.1 million in 2008, and $102.8 million in 2010. The report projects that costs will rise to $109.2 million in 2011, $119.3 million in 2012, and $131.7 million in 2013.

Starting in 2014, the major provisions of federal health care reform — known as the Affordable Care Act — are slated to take effect. At that point, more than 800,000 uninsured Washingtonians will be eligible for expanded Medicaid eligibility or subsidies to help low- and middle-income families pay for health coverage, according to Kreidler. As a result, the state’s uninsured rate is expected to plummet from a high of more than 15 percent at that point to 5 percent, according to Kreidler.

The study also found that charity care and unpaid medical bills at hospitals and health care providers’ offices have reached approximately $1 billion a year in Washington. Much of that cost is passed along to patients with health coverage.

“For many families struggling to get or keep health coverage, 2014 can’t come soon enough,” said Kreidler. “As things stand now, we have hundreds of thousands of people living one bad diagnosis away from bankruptcy.” This is the third report on the uninsured from Kreidler since 2006. “If anyone doubts the need for health care reform,” said Kreidler,”there are a million people out there that they should talk to.”

The complete report is online at http://www.insurance.wa.gov/legislative/uninsured-washington.shtml .