Will health reform provide for the needs of vulnerable populations?

States are increasingly turning to managed care as a means of coping with exploding Medicaid costs (see Emily Friedman's article in the March 16 JAMA, pp. 875-78). Many managed care proposals depend on employer-based insurance as the primary source of financing health care reform. Debates continue, however, over the ability of both to provide adequate care for the diverse sets of populations in the United States.