Premium assistance is the use of public funds through Medicaid or the Children’s Health Insurance Program (CHIP) to purchase private coverage. States have pursued premium assistance with varied objectives, including covering parents not otherwise eligible for public coverage and promoting the use of private coverage. Implementation of the Affordable Care Act (ACA) coverage expansions is likely to spark renewed interest in premium assistance options. This brief provides an overview of premium assistance options and examines how the ACA may impact the use of premium assistance.