Susan Jackson works 30 hours a week as manager of Meadow Garden, the historic home of George Walton.

"I feel like it's full time," she joked.

Like many jobs, hers did not come with health insurance, and she could not afford to buy it on her own, leaving her feeling a little anxious and vulnerable.

"You think, 'God, please let me stay well,' " said Ms. Jackson, 63.

She has a lot of company in Georgia, South Carolina and across the country. Consumer group Families USA released a report Tuesday that showed one in three people younger than 65 -- nearly 3 million people in Georgia and 1.3 million in South Carolina -- were without health insurance at some point in 2007 and 2008. And that was before the worst of the recession hit, said Families USA Executive Director Ron Pollack.

"Undoubtedly, it got worse," he said. "The huge number of people without health coverage in the United States is worse than an epidemic."

Most are like Ms. Jackson -- nearly 78 percent in Georgia and nearly 80 percent in South Carolina were working full or part time, according to the report.

The numbers are even worse for minorities -- the rate of the uninsured among blacks is nearly dou- ble what it is for whites in Georgia, and Georgia and South Carolina lead the nation in the rates of un- insured Hispanics -- more than two out of three lack coverage.

It is possible that the data from the Census Bureau and the Agency for Healthcare Research and Quality is picking up some migrant workers, said Kim Bailey, senior health policy analyst for Families USA and the author of the report.

But it is also likely that Hispanics are working in jobs in the agricultural or service sectors where health benefits aren't offered and low wages don't allow workers to buy their own, she said.

The numbers point to an urgent need for health care reform this year, which Mr. Pollack said he believes will happen.

"It is our hope and expectation that the Congress, working together with the president, will achieve meaningful health care reform," he said. "And that reform can lead to access to high-quality, affordable health care for everyone."

The group favors subsidies for those who can't afford to purchase insurance on their own and a "floor" for Medicaid eligibility that will ensure minimum coverage in each state.

Because a lot of this depends on how those limits are set, Mr. Pollack said he couldn't offer a price tag, but key committees in Congress are at work now gathering this sort of detail.

Ms. Jackson, who has been without coverage since 1993 after a divorce and a job change, considers it "a blessing" that she found a medical home at the Belle Terrace Health and Wellness Center, which charges her a sliding-scale fee.

About half of the center's 4,000 or so patients are uninsured and, judging by the popularity of after-hours appointments, they are working families as well, said Executive Director Melinda Rider.

Ms. Jackson needs ongoing care for her asthma and cholesterol, and she said it is both affordable and top-notch.

"When you're left without health insurance, you feel helpless," she said. "You feel like, 'What am I going to do?' It's just good you've got a place like this. But it's also a good medical staff and a good doctor."