Simplification and alignment of policies for children in Medicaid and CHIP have helped states fill the gap in private insurance and achieve record levels of coverage for 90% of our nation’s children. These lessons are carried forward in the Affordable Care Act’s expansion of coverage through Medicaid and the Exchanges. The ACA envision a customer-friendly, paperless system where coverage options are aligned, enrollment processes are simplified, and technology is used to verify eligibility. The following issue-brief investigates current state efforts to align and simplify coverage for children and parents in Medicaid and how the ACA moves states toward a more coordinated system of family-based coverage.