A central goal of the Affordable Care Act (ACA) is near universal access to affordable health insurance through Medicaid, the Children’s Health Insurance Program (CHIP), and subsidies to help purchase private coverage in the new Health Insurance Marketplaces. As states full implement the ACA, they are modernizing the way Medicaid and CHIP do business, including re-examining whether requiring children to be uninsured for a period of time prior to enrolling is conducive to promoting administrative efficiency and advancing coverage. As a result, 22 states have eliminated their waiting periods and five states have decreased their waiting periods to 90 days or less to comply with updated federal regulations.