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Several studies conducted as part of the Urban Institute's Assessing the New Federalism project have focused on documenting and explaining racial and ethnic differences in insurance coverage and health care access and use. ANF's National Survey of America's Families has enabled studies of trends in insurance coverage gaps, analyses of under-studied populations, and multivariate decompositions of the factors related to racial and ethnic differences. This paper reviews those studies and highlights their contribution to the large and growing literature regarding racial and ethnic differences. It supplements the review with findings from the authors' analyses of the 2002 NSAF.