The promise is an ongoing-effort commitment: to "continue working with Senate colleagues to reform the health care system." Crapo demonstrably LED that work rather than merely participating. As Senate Finance Committee Chairman he authored and introduced the Health Care Freedom for Patients Act alongside HELP Chairman Bill Cassidy in December 2025 — a comprehensive ACA-reform proposal creating pre-funded, patient-driven HSAs; it failed to reach the 60-vote threshold (blocked 51-48). He is also the confirmed SPONSOR (not merely a cosponsor) of the bipartisan Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act (S.339), whose provisions were signed into law on Feb. 3, 2026 (enacted via H.R. 7148, the Consolidated Appropriations Act, 2026), expanding Medicare coverage for cancer screening. Together these show real leadership on health-care reform — sponsoring, authoring, and co-leading legislation, not merely casting votes — which is the essence of a "continue working to reform" pledge, so the outcome is CHAMPIONED rather than a bare FULL. It is not rated FULL/higher-confidence because the aspirational end-clause ("so all Idahoans can receive needed care") is contested and unmet: his flagship systemic reform failed, and his market-based approach's effect on universal access is disputed. It is not PARTIAL/ATTEMPTED because he clearly and continuously led health-care reform efforts and secured enactment of at least one bipartisan health measure he sponsored. Confidence is moderate because the promise mixes a clearly-kept effort commitment with a subjective, unmet access goal.