To a surprising extent, given the weakening economy and growing fiscal strains, states have continued to move forward in their efforts to expand and improve health coverage for children. Notably, over the last year, nineteen states provided health coverage for more uninsured children and families by expanding Medicaid and the State Children’s Health Insurance Program (SCHIP) and/or cutting red tape to make it easier for eligible children to enroll, and stay enrolled, in the programs.