Health programs often fall short of their coverage goals. Even the Children's Health Insurance Program, now quite successful in reaching uninsured children, suffered low enrollment during its early years. By contrast, other programs rapidly achieved high participation by using reliable data to identify eligible consumers and qualify them for assistance. Federal policymakers implementing the Affordable Care Act could thus pursue a strategy with five parts:

1. A proactive national campaign to identify and enroll the uninsured via the tax system;
2. Basing eligibility on reliable data;
3. Providing hands-on application assistance;
4. Consumer-friendly enrollment systems; and
5. Effective interagency coordination.