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We are concerned that providing insurance for the previously uninsured will be seen as a panacea for resolving health disparities, for the social environment makes a tremendous difference in health outcomes. A careful examination of the factors involved in the social determinants of health shows that health insurance plays only a small role in alleviating health disparities. In this commentary, we highlight the complexity of the problem of the social determinants of health and health disparities in the United States by comparing two neighborhoods in Baltimore City and by examining hypertension and mental health disorders.