KANSAS CITY, Mo. — The number of Americans forced to go without health insurance skyrocketed during the recession.

According to a new report released this week, 9 million Americans who lost their jobs in 2008, 2009 and the first half of 2010 either couldn't afford or couldn't get replacement coverage. That pushed the number of uninsured Americans past 50 million.

The analysis of those left completely uninsured in the recession is based on findings from the 2010 Commonwealth Fund Biennial Health Insurance Survey.

In the report — which advocates for universal coverage under a national health overhaul — the research organization said 60 percent of those left uninsured during the recession couldn't find a replacement plan they could afford and 35 percent were turned down for coverage by insurers.

The report said health coverage provided through the Consolidated Omnibus Budget Reconciliation Act — COBRA — was a good solution for some jobless Americans until the federal subsidy provided through the 2009 recovery act expired.

That subsidy, which covered 65 percent of COBRA premiums, has not been extended to laid-off workers since 2010.

The U.S. Bureau of Labor Statistics calculated that more than 45 million people were laid off or discharged from a job from 2008 to 2010. About 15 million lost all access to job-based health insurance. And of that number, 9 million couldn't afford or couldn't get new coverage either through COBRA or by buying individual policies.

"Once you are unemployed and uninsured, it's nearly impossible to afford COBRA or buy an individual policy," said Commonwealth Fund Vice President Sara Collins, a co-author of the report. The report was based on a survey taken by Princeton Survey Research Associates.