One of welfare reform's unintended consequences has been a reduction of health care coverage among poor Americans. The welfare law severed the link between cash assistance and Medicaid. In turn, Congress provided states with several options to continue to offer Medicaid to those leaving welfare and to expand health coverage to more low-income families. Nonetheless, many low-income people lost health care coverage as they moved from welfare to work. This paper provides a statistical portrait of changes in health insurance coverage, and the policy measures that states have taken to fix the problem.