The recession coupled with rising health care costs has taken a stiff financial toll on most Americans -- but no one more than the middle class, according to a new report from the Robert Wood Johnson Foundation.

The number of middle-income Americans who get health insurance from their employers fell by 3 million people from 2000 to 2008, according to the report called Barely Hanging On: Middle-Class and Uninsured, which offers state data on the issue. Today about 66 percent of people who earn between $45,000 and $85,000 get insurance through their jobs.

In Maryland: 

• The number of middle-income people who were uninsured increased from 160,000 in 2000 to 240,000 in 2008.
  
• About 12 percent of private-sector employees worked for companies that didn't offer health insurance.
  
• Even for those with insurance through their employer, costs are rising. A family insurance policy increased 46 percent from 2000 to $12,651 in 2008.
  

While lower income earners can qualify for Medicaid and people with higher incomes can afford to purchase coverage on their own, those in the middle are getting squeezed, the report explains. If you're middle class you typically don't qualify for government insurance programs, so getting coverage through your employer is often the only feasible option.

The report is part of the organization's effort urging for coverage of the uninsured. It so happens to correspond with this week's big showdown in the House on the health care bill.

Does your employer still offer coverage? How much has your plan increased in recent years? How are you holding up?