In 2003, more than 1.4 million North Carolinians were uninsured, and the number of uninsured was increasing rapidly. Lack of insurance coverage affects not only the uninsured and their families, but also health care institutions that have a mission to serve the uninsured. The NCIOM Task Force on the Healthcare Safety Net explored ways to strengthen and expand the safety net to better meet the health care needs of the uninsured. This report presents the task force’s findings and recommendations.