The health research and policy communities have made significant progress in recent years in improving the data and analysis needed by federal, state, and local officials to guide policymaking on the uninsured. If the United States provided universal coverage to all Americans and had implemented a uniform electronic medical record, we might not have to depend on survey data as much as we currently do to assess the extent and consequence of being uninsured. Health surveys can provide critical information on insurance coverage and access to care at the national, state, and community levels that policy makers need to monitor the performance of the health care system and to develop programs to respond to shortcomings like excessive cost growth, uneven quality, and inequitable access to coverage and care. The principal federal agencies that produce these data are the United States Department of Commerce's Census Bureau, the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS), and the Agency for Healthcare Research and Quality (AHRQ). Recognizing the need to augment the availability of reliable and timely state and community health data produced by the federal agencies, national foundations over the last several decades have sought to fill identified gaps—both in the questions asked and the ability of these surveys to produce estimates at the state and substate level. These data help national policy makers understand the variations across our nation and help state and community leaders develop programs to meet the needs of their citizens. For example, in 1993–1994, the Robert Wood Johnson Foundation (RWJF) funded the State Initiatives in Health Care Reform Program, which included both population and employer surveys in 10 states to assist those states in developing their plans to meet the needs of their uninsured populations. More recently, RWJF funded the Community Tracking Study to provide information on 12 metropolitan communities. The National Survey of America's Families, which was co-funded by the Annie E. Casey Foundation, W. K. Kellogg Foundation, RWJF, the Henry J. Kaiser Family Foundation (KFF), and other philanthropies, gathered information on 13 diverse states that account for a large share of the nation's population. The Commonwealth Fund fielded multiple surveys on employer-based health insurance and KFF, along with Health Research and Educational Trust, continue to conduct an annual survey of employers. With this background and attention to the changing funding priorities of national foundations, AcademyHealth initiated a review of current national surveys being used to guide coverage and access policy. The results of this assessment are provided in AcademyHealth's report, Improving Federal Health Data for Coverage and Access Policy Development Needs. The most notable example of the change in national foundation priorities is the decision by RWJF to no longer fund large, nationally representative surveys of households and employers. These surveys have in the past yielded some state- and community-based estimates. Given the decision to discontinue these major sources of data that policy makers at all levels had been using to supplement ongoing federal health surveys, it is now more critical than ever to strengthen federal health data to meet these important needs. The national health reform deliberations in the early 1990s and policy makers' demands for more state-level data led to notable improvements by the federal agencies in focusing on states as relevant geographic areas for estimates, as well as improving the speed with which data was released. Other programs evolved during this same period and debate, fueled in part by greater understanding of national and state-level variations in insurance and access. When the federal government did not enact substantial health reforms in the early 1990s, state governments were left to focus on incremental policies as the only viable option for addressing the issue of the uninsured. The federal enactment of the Health Insurance Portability and Accountability Act and the State Children's Health Insurance Program provided some direction for further reform of insurance markets and for expanded coverage for children of moderate income families. To prompt states to consider an even broader range of reforms, the federal government also provided states with funding to develop plans or enhance current programs to address the uninsured through the Health Resources and Services Administration's (HRSA) State Planning Grants program. Most states used at least a portion of their HRSA grant funds to conduct their own state-specific surveys, assessing both the extent of their uninsured problem and providing data to inform policy choices about different approaches for expanding coverage and access. For 2006, the Bush administration did not request additional funding for this program and states will have exhausted their HRSA funding by 2007. Without supplemental foundation funding or HRSA funds to support state surveys, states will now have to use their own scarce resources to gather data or rely upon the existing federal health surveys. Besides these policy concerns, health services researchers are concerned about their ability to gain timely access to federal health data. Researchers were frustrated by the length of time it took AHRQ (then the Agency for Health Care Policy and Research) to release National Medical Expenditure Survey public use tapes. Though AHRQ has since shortened the time lag, Medical Panel Expenditure Survey (MEPS) files become available 2 years after the year for which they are collected. While researchers may not always fully appreciate the time it takes to process, prepare, and “clean” the data for public use, it is time to revisit the critical trade-off between quality and completeness of the data file and its more timely release, given the policy community's growing need to have closer to real-time data to monitor system performance and make critical policy decisions. Based on the findings from its Federal Health Data Project, Academy- Health believes that both more federal funding and a strategic refocusing of current surveys are needed. If limited funding increases remain a short-term reality, we urge the federal government to continue its efforts to streamline and refocus current data collection resources to generate both more timely data release and more state- and community-specific data.