The strength or weakness of a state's safety net does not affect the gap between the insured and uninsured in access to and use of health care services. With few exceptions, the gap in access and use was no larger in states with the most vulnerable safety nets than in states with the least vulnerable safety nets. This report classified 13 states on safety net vulnerability and uses the National Survey of America's Families (NSAF) to measure access and utilization of health coverage. Regardless of the safety net's vulnerability, the uninsured in all states do have access to care and do use services, although the levels are well below those of the insured. While the gaps between the uninsured and the insured show little variation among states, low-income populations are better off in states where they are more likely to be insured.