Arizona, with its large number of uninsured residents, was primed to make major progress in 2014 with the full implementation of the Affordable Care Act. With the adoption of the Medicaid expansion, the state did see coverage improvements that mirrored national trends. Yet the state’s decision to dismantle KidsCare meant some Arizona children likely fell through the cracks and prevented more significant gains in children’s coverage enjoyed by neighboring states. Arizona stands at a critical crossroads as the only state without an active CHIP program. The state now has an important opportunity to accept full federal funding available to ensure more children receive affordable, high-quality health coverage.