In 1998, Governor Pataki and New York legislators created one of the country's most innovative programs for enrolling uninsured children and teens in public health insurance. Launched in 2000, the facilitated enrollment program uses community-based organizations and health plans to find and enroll "hard-to-reach" New Yorkers who have historically been left out of public health insurance. In 2001, the program was expanded to include adult-focused outreach and enrollment. Approximately 1.3 million of the state's uninsured are eligible for, yet simply not enrolled in, free or low-cost coverage through one of New York's four principle public insurance programs: (1) Child Health Plus A; (2) Child Health Plus B; (3) Medicaid; and (4) Family Health Plus. Often, they remain uninsured because they do not know they are eligible or because they confront insurmountable barriers to enrollment such as complex enrollment systems, language, limited literacy skills, rural distances, lack of transportation, fear or the inability to miss work to apply. This report focuses on the highly effective work of the more than 100 community-based facilitated enrollment agencies funded by New York State to conduct locally tailored outreach and enrollment in New York's public health insurance programs. These multi-service agencies, health and human service providers, immigrant service organizations and local government agencies meet the uninsured where they are, where they live, work, go to school and carry on everyday activities. Since 2000, they have enrolled more than 600,000 children, teens and adults. Tens of thousands more have received help with the often difficult annual renewal process. Recent Census data indicates that New York has 250,000 fewer uninsured children today than when facilitated enrollment was created. More low-income adults are also getting the health care they need to stay healthy and continue working. Pressure to relieve the burden of rising health care costs on local taxpayers has led to proposals to cut outreach, enrollment, eligibility and benefits in public health insurance programs. This report underscores the tremendous value these programs have in the lives of low income New Yorkers. In particular, it highlights how community based facilitated enrollment has brought health care access into the hearts of communities throughout New York State. Recommendations for the future include: (1) Fully funding the community based facilitated enrollment program; (2) Expanding the role of community-based facilitated enrollment projects to ensure that the people they enroll access the health care they need; (3) Streamlining the enrollment process for New York's public health insurance programs; (4) Modernizing the enrollment process through enhanced information technology; and (5) Protecting New York's public health insurance system against efforts to cut outreach, enrollment, eligibility and benefits. Statistics show that community-based facilitated enrollment is an effective and cost efficient investment to ensure that New York's public health insurance programs reach the families and individuals they were designed to serve. [This report was made possible with the generous support of the Altman Foundation.]