The passage of the Patient Protection and Affordability Act should remove the financial barrier to mammography screening by expanding coverage and eliminating cost sharing in Medicare and private plans; however, barriers remain. For example, in 2008 the difference in mammography prevalence between women with and without health insurance was 27.5%. Even among women with health insurance, 16.2% had not received mammography in the preceding 2 years. Similar differences in receipt of mammography by insurance status were noted in a 2009 study.9 These findings suggest new roles for public health to improve screening through increased education of women and providers, and through additional targeted outreach to underscreened groups including lower SES, uninsured and select minority groups. Several evidence-based interventions are recommended by the Guide to Community Preventive Services to increase mammography screening in communities.∥ These include sending client reminders to women, using small media (e.g., videos, letters, flyers, and brochures), and reducing structural barriers (e.g., providing more convenient hours and increasing attention to language, health literacy, and cultural factors). Surveillance with targeted outreach, case management, and quality assurance through systems change are productive future roles for public health agencies to improve the delivery of clinical preventive services in the era of health reform.