We review pertinent aspects of the history of the space launch capabilities of the United States and survey its present status and near-term outlook. Steps which must be taken, pitfalls which much be avoided, and a core set of National options for re-acquiring in the near term the capability to access the space environment with large payloads are discussed. We devote considerable attention to the prospect of creating an interim heavy-lift space launch vehicle of at least 100,000 pound payload-orbiting capacity to serve National needs during the next dozen years, suggesting that such a capability can be demonstrated within 5 years for less than $1 B. Such capability will apparently be essential for meeting the first-phase goals of the President's Space Exploration Initiative. Some other high-leverage aspects of securing American access to space are also noted briefly, emphasizing unconventional technological approaches of presently high promise.