In summary, a substantial proportion of Hispanic and low-income chronically ill children with special needs have neither private insurance nor Medicaid coverage. Those who averaged the fewest doctor visits during the past year for their condition (such as black or low-income children) also tended to be more likely to be hospitalized. Children who did not live with a biological mother or biological mother and father were least likely to have been to a physician or to be taking prescribed medications for their condition. These analyses pinpoint chronically ill children with special needs who are likely to have the least access to routine medical care. Further research is warranted to estimate the probable impact of the differential nonresponse and underreporting by minority and low-income respondents on these estimates.