This report examines policy options for increasing health insurance coverage of employees of small businesses in Texas. Specifically, the report describes reforms made in Texas in the early 1990s to the small employer market and assesses the current situation in the state. Next, the report examines reform efforts in Florida, New York, and California to assess the viability of using models in those states to improve the situation in Texas. Finally, the report discusses options for the future of small employer health insurance reform in Texas.