Despite significant changes in the market and policy environment, major safety net hospitals and clinics have so far been able to maintain their commitment to the uninsured. While several factors are making it harder for safety net providers to provide care to the uninsured, this paper finds that very few have closed and none of the major providers have reported reductions in their capacity to care for the uninsured. The authors identify and discuss three primary reasons for the resilience of these health care providers.