Mounting empirical evidence, policy research, and reports in the popular press attest that the U.S. health care system is currently inadequate to ensure access to care for those with the greatest health care needs. This brief shows that low-income adults with high health costs and employer-sponsored health insurance spend 10 percent of their income on out-of-pocket expenses; those with non-group coverage spend at least double that figure. We describe three options for subsidizing health care coverage for high-cost, high-risk populations. Low-income subsidies could further reduce the cost of care and coverage for people of modest means.