In the last 30 years the health status of black women has improved. However, the likelihood of health problems from complications of pregnancy and childbirth or prolonged illness from combined effects of diabetes, hypertension, and obesity remains. The need for continuity of care for these conditions and the low economic status of black women suggest that current policy shifts away from emphasis on increased access to medical care will adversely affect the health status of black women. Policies to contain health-care costs should therefore be designed to assure appropriate access to needed care for black women and other low-income groups.