20% of VIM’s target patient population is uninsured for at least part of the year; 5% all year. Even here in Massachusetts, where “universal” coverage was enacted in 2006 under the Commonwealth Care program, there are still huge gaps. The Blue Cross Blue Shield Foundation of Massachusetts, in conjunction with The Urban Institute, has conducted periodic surveys to determine the effectiveness of the commonwealth’s program.  Although we are among the best in the nation in total coverage, there are significant gaps among key segments of the population.  The most recent survey found more than 20% of non-elderly adults (19-64) with incomes under 300% of the Federal Poverty Guideline (VIM’s patient profile) were without health insurance for at least part of the year and about 5% had no coverage at all during the previous year.  As recently as last summer, the Gallup Organization conducted a similar phone survey with similar results.