The problems of access, adequacy, and affordability of health insurance for persons with severe chronic conditions are analyzed. Part 1 defines the target population by considering conceptual and methodological issues, and examines statistics from various national surveys. Part 2 examines the distribution of health insurance throughout the population by age, family income, employment, and health status, and then compares the health insurance status of persons with and without disabilities. Attention is focused on the working-age disabled population, divided into those who are employed, those receiving public health insurance, and those neither employed nor recipients of public health insurance. Part 3 explores the limitations of acute care-oriented health insurance for meeting such special needs as rehabilitation, maintenance therapies, personal assistance services, durable medical equipment, assistive devices, disposable medical supplies, and drugs. Part 4 identifies barriers to adequate and affordable health insurance, including medical underwriting, the cost of health care services in relation to the income of persons with disabilities, and the limitations imposed on health insurance plans because of pre-existing conditions. Part 5 examines national survey data on health care costs and utilization patterns for persons with disabilities, critiques the limitations of the data, and identifies areas for further research. (JDD)