Blue Cross and Blue Shield plans across the country were created with the intention of providing affordable healthcare coverage in the nonprofit context with a community focus. The plans were established to fill significant holes in the healthcare system. They were created and promoted by the community, acting in the public benefit. Their history and involvement in creating an alternative healthcare coverage source—the voluntary, nonprofit prepaid health plan—and their subsequent participation in the development of the Medicare and Medicaid programs have helped ensure that more Americans obtain access to healthcare coverage.