This study examines how uninsured adults with chronic health problems are faring vis-a-vis access to care. The analysis is based on the 2003 National Health Interview Survey, relying on self-reports of chronic health conditions. We find that almost half of uninsured adults with chronic conditions forgo needed medical care or prescription drugs due to cost and that they forgo care at much higher rates than their insured counterparts. Serious identifiable gaps in needed medical care were found for every racial, ethnic, and chronic illness subgroup examined.