More than 20 percent of people said they either delayed getting needed medical care or did not get it during the past 12 months, according to a study from the Center for Studying Health System Change. That represents a significant increase from the 14 percent who responded similarly in 2003. Last year, more than 23 million people reported going without needed care and about 36 million people delayed care, according to the center’s Health Tracking Household Survey. The national survey, conducted five times since 1997, showed the sharpest increase in access problems in a decade, particularly among insured Americans. Uninsured people continued to face the greatest access problems and were almost three times as likely to report going without care as insured people—17.5 percent compared to 6.3 percent. However, insured people experienced a greater percentage increase in unmet medical needs compared with uninsured people—a 62 percent increase for the insured compared to a 33 percent increase for the uninsured. As a result, ironically, the access gap between insured and uninsured people narrowed slightly. In 2003, uninsured people were 3.4 times as likely to report going without care as insured people and 2.8 times as likely in 2007.