India faces major challenges in sustaining the health gains achieved in the better-performing states and ensuring that the lagging states catch up with the rest of the country. In this paper we examine the current status of health financing in India, as well as alternatives for realizing maximal health gains for the incremental spending. A principal conclusion is that public expenditures of an additional US$6–US$7 per person per year (about 1 percent of gross domestic product) would, if focused on about sixteen key interventions, provide universal access to those interventions and have a favorable affect on population health.