Wisconsin officials during the 1990s seemed poised to enact innovative and comprehensive health care reform. During that era, an ambitious, popular, and reform-minded governor led the state. The state had an unusually professional legislature. The state's economy was strong. Even with these advantages,however, the report card on the state's efforts is mixed. The state enacted a fairly modest set of reforms that were financed largely by the federal government and subject to extensive federal oversight. The Wisconsin story thus seems to be about the politics of incrementalism. But while critics of incrementalist politics point out that the number of uninsured continues to grow, the catalytic federalism witnessed in Wisconsin in the 1990s may well be the best model for implementing health care reform.