A front page story in today's New York Times summarizes the challenges that have faced the universal coverage effort in Maine. Unsurprisingly, health care has turned out to cost more than the state government there originally projected. One reason is that "premiums have increased, not become more affordable, because some of those who signed up needed significant medical care, and there are not enough enrollees, especially healthy people unlikely to use many benefits." The coverage that the state is offering has attracted 18,800 enrollees so far, nowhere near the original targets.  Maine is adjusting, hoping to get closer to the results they'd planned on (coverage for 130,000 uninsured state residents by 2009). As we watch individual states--Maine, Massachusetts, California--take incremental steps toward achieving universal coverage, we're witnessing both the successes and failures that will likely unfold across the nation.