The number of uninsured Americans dipped slightly last year - from 47 million to 45.7 million - but many experts say the number still signals a crisis in America.

"Big deal. The number went down a little," said Paul Fronstin, director of the health research and education program at the nonpartisan Employee Benefit Research Institute. "That doesn't mean the issue is any less important. Doesn't mean we're on the right track."

The decrease fails to reflect "what's going on right now," Fronstin added. "We have a much weaker economy than a year ago, much higher inflation. Very unlikely that this trend will continue into 2008."

The modest decrease - the first in years - resulted because 2.7 million more Americans, many of them children, were insured by government programs, such as Medicaid.

Leonardo Cuello, acting executive director of the Pennsylvania Health Law Project, which helps poor and sick Pennsylvanians get insurance, said the new census data show only that "in face of crisis, different states are doing the best they can to come up with Band-Aid solutions."

In Massachusetts, for instance, which mandates coverage, the state insured 125,000 more children last year, and saw an overall drop in the number of uninsured by 2.4 percent.

The overall system is very, very sick," Cuello said.

"What people should really understand," he added, "is this fact: The majority of those people without insurance are employed."

Consider a few of them:

Jim Cade, 60, who runs an auto body repair shop in West Philadelphia, still fixes his doctor's car in return for primary care and prays daily he doesn't need anything more.

Melva Ann Williams, 52, of Media, cares for her twin 16-month-old foster children and her sick mother, all of whom are insured by government programs, but she can't afford insurance for herself. She gets by because her doctor gives her free samples of blood-pressure medication every month.

"If it wasn't for him," she said, "I'd probably have died from stroke by now."

Troy Evans, a part-time UPS truck driver in Toms River, N.J., went to the emergency room with chest pain, which turned out to be nothing more than sore muscles from working out in the gym.

What also hurt were the medical bills - more than $20,000, he said. He filed for bankruptcy in February.

Pennsylvanians lacking health insurance fell slightly from 1.237 million in 2006 to 1.176 million, or 9.6 percent of the population, in 2007, and, again, most of that drop can be attributed to an increase in government programs.

Pennsylvanians getting insurance through Medicaid and S-Chip, the State Children's Health Insurance Program, rose from 11.9 to 12.3 percent, according to Sharon Ward, director of the nonpartisan Pennsylvania Budget and Policy Center.

The state's rate is lower than New Jersey's. During the last three years, according to the census data, the number of uninsured has averaged about 1.3 million, or 15.2 percent of New Jersey's population.

Sam Marshall, president of the Insurance Federation of Pennsylvania, said the national number was still too high. "Whether it's 47 million or 45 million uninsured Americans, that's not an acceptable number," he said.

He said he believed many of the uninsured were healthy young people who needed to be taken into the system. You can't have a viable health insurance system, he said, when people wait until they are sick to get coverage.

Marshall said he was heartened that the number of Americans with private insurance declined ever so slightly, from 67.9 percent in 2006 to 67.5 in 2007.

"I realize as difficult times continue, you may see people dropping coverage as they lose jobs or employers cut back," Marshall said. "We're just as concerned with keeping costs down for those who have coverage as with getting the 45 million into coverage."

Gov. Rendell has been negotiating with Republican members of the state Senate to pass Senate Bill 1137, known as Pennsylvania Access to Basic Care, which would reduce the number of uninsured.

The Senate will be in session for only eight or nine days in September, but Donna Cooper, Rendell's secretary of policy and planning, said she hoped the bill would be ready for a vote.