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Another 1.3 million Americans were without health insurance last year, more of them in the South than in most other parts of the country, according to new Census estimates.

South Carolina was one of eight states nationwide where the uninsured rate rose, Census officials said.

A total of 46.6 million Americans were uninsured in 2005 -- 19.8 million of them in the South -- and that's up from 15.6 percent of the population in 2004 to 15.9 percent in 2005, the Census Bureau reported Tuesday. By comparison, there were 12.4 million uninsured people in the West, 7.8 million in the Midwest and 6.7 million in the Northeast.

The number of uninsured children increased by 400,000 to 8.3 million, said Dr. Georges Benjamin, executive director of the American Public Health Association, adding that children in poverty were the most likely to be uninsured. The same report shows that the South continues to have the highest rate of poverty -- 14 percent.

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The numbers tell the story of the influx of Hispanics and regional growth. Of the 1.3 million, nearly half, or 618,000, were Hispanic, according to Census spokesman Robert Bernstein, though just 1 percent of them weren't citizens. Yet Hispanics represent just 14 percent of the population.

And 703,000 of that 1.3 million were in the South, he said, where the rate of people without insurance increased from 18.2 percent to 18.6 percent.

South Carolina is one of eight states where the uninsured rate rose. It stayed the same in most states, Bernstein said. The state's Hispanic population grew 47 percent in that time.

The increasing number of Hispanics is part of the story, said Karen Davis, president of The Commonwealth Fund, a private foundation that researches health care issues. Another is the continuing erosion in employer-sponsored health insurance, she said.

"Of the 1.3 million increase, about 900,000 are working adults," she said. "Employers are responding to the increase in premiums and cutting back on coverage."

Employers are dropping insurance, says Susan Lill, president of Align HR, a Greenville human resources consulting company. But they're also trying to find other ways to provide coverage, she says, such as health savings accounts, association health plans, and contracting directly with health care providers.

"Business organizations need to be creative and think outside the box," she said.

Lori Cashin, director of the United Way of Greenville County's Building a Healthy Community Impact Council, which is working with area health-care providers on access issues, called the numbers "alarming."

And Suzie Foley, executive director of the Greenville Free Medical Clinic, said she was not surprised by them.

John Holahan, director of the Health Policy Center of the Urban Institute, says the problem is only going to get worse.

"The only real solution is some sort of government intervention," he says, "either through expansion of government programs or tax credits so people can buy private coverage."

Gov. Mark Sanford supports health savings accounts and other ways to make coverage more affordable for small business, spokesman Joel Sawyer said.

Sanford also is pushing for changes to reduce spending in the state's $4.5 billion Medicaid program -- $1.16 billion of it in state money -- to enable continued coverage, he said.

"We don't think the solution is through tax increases and mandates to provide coverage," he said.

Davis says the country needs to seriously consider alternatives to employer-based coverage or at ways of shoring it up.

"What's on the table is pretty inadequate to deal with the problem," she said. "We need leadership from the federal government."