This issue brief presents data showing the role that flexibility in the SCHIP program has played in allowing states to address the growing gap in health insurance affordability among the nation’s children. It focuses on the increasing costs to families of securing health coverage, both in terms of the absolute costs and as a proportion of income. The issue brief shows that by allowing states the flexibility to decide which children to cover under SCHIP, they are able to take into account local variations in terms of the cost of living, expand coverage to those with higher incomes, and implement appropriate cost-sharing mechanisms.