In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA), also known as the Kassebaum/Kennedy reforms. These reforms were the piece that derived from the tremendous health care debate of the early 1990's. The reforms had many intended roles. Included among them was providing coverage to those who were not offered coverage because they represented too high a health risk, providing greater portability for coverage by limiting pre-existing condition restrictions, and providing greater access to coverage in the group market. The first chapter looks at the background of the health care reform debate as well as national insurance statistics. Chapter Two looks to the policy of federal regulation, and the power of Congress to regulate the states. Chapter Three is a look at the reforms from a federal perspective and the options the reforms provide for compliance. Chapter Four is an application of those reforms at the state level, and Texas' specific implementation of the reforms. The final chapter covers the future of the reform process in Texas and possible recommendations for the future, as well as a look at the future of health care reform.