This report synthesizes all of the research and analytic work done on the Roadmap initiative, describes three policy approaches that would achieve universal health coverage in the Commonwealth, and describes the issues that would need to be addressed in order to implement the Roadmap options. The report describes each of the building blocks in turn, followed by the mandate alternatives. The cost and coverage estimates were produced using the Health Insurance Reform Simulation Model, developed by Urban Institute researchers. The report also discusses options for financing the coverage expansions, the likely benefits from universal coverage, and the broader economic impacts.