The Children’s Health Insurance Program (CHIP), which was enacted twenty years ago, covers uninsured children who do not qualify for Medicaid but lack access to affordable coverage. Together these safety-net programs have boosted the health insurance coverage rate among US children to historic levels, exceeding 95 percent of children in 2015. However, the future of both CHIP and Medicaid is uncertain. In the current congressional debate over the Affordable Care Act, Medicaid has become a target for potential funding reductions and other changes that would undermine the scope of children’s coverage. Congress has yet to act to extend CHIP funding beyond September 30, 2017, when the current appropriation expires. State and federal policy makers should act now to preserve the foundation of coverage currently in place while striving to ensure that every child in the United States has health coverage.