The primary health care issue facing youth, and most other Americans, involves the ability to access and pay for needed services. Health care reform is especially significant to young people since many live in at-risk environments characterized by concentrated poverty. Applying health care reform to services for youth, however, is complicated and unique. For adolescents, particularly those living on their own, age-related health needs and behaviors place them at risk for health problems, including pregnancy and sexually transmitted diseases. Therefore, an appropriate health care delivery system for young people is needed that focuses on health care financing and coverage. The Clinton Administration has addressed adolescent health care needs in several initiatives related to crime and welfare reform. These initiatives recognize the importance of systemic change if the needs of young people are to be met. The Community Schools Youth Services and Supervision Grant Program, enacted in the Crime Bill (P.L. 103-322), will provide resources to local community consortiums to provide services and activities to young people through existing local facilities. Clinton's welfare reform proposal, the Work and Responsibility Act of 1994, aims to prevent teenage pregnancy and create access to health care for adolescents. The author stresses the importance of establishing a national youth policy to address the varied needs of young people.