This report examines changes in Missouris health insurance coverage between 2000-2004. During this period the state experienced a recession followed by a period of slow economic growth. The paper presents extensive data on the relationships between employment, employer-sponsored insurance, and uninsurance through the use of demographic variables between the years 2000-2004. It also provides a broad overview of how individual states are confronting the nationwide challenge of constraining health care costs. It offers a timely and much-needed view to a range of policies, as well as their potentials and their costs.