With the new options in CHIPRA, a new Administration in Washington, and the potential for health care reform on the horizon, the time is right to highlight the most promising federal actions that would close these remaining coverage gaps for uninsured children and adults. This report identifies new strategies as well as some variations in concepts that have been around for many years that could help states get closer to the finish line by enrolling and retaining eligible children and families in Medicaid and CHIP.