On April 16, 1999, a distinguished group of health economists, policy analysts, and journalists met at the Urban Institute to explore the details of a premium support approach to Medicare reform. Under current policy, Medicare is projected to become financially unsustainable sometime within the next 20 years. With this and related concerns in mind, Congress established, in the Balanced Budget Act of 1997, the National Bipartisan Commission on the Future of Medicare. Among other duties, the Commission was charged with making recommendations to Congress by March 1, 1999, on a comprehensive approach to preserving the program.