For 25 years, low-income, non-citizen Los Angeles County residents ineligible for Medi-Cal coverage have had access to emergency, pregnancy-related, and nursing home services through the Emergency Medi-Cal (EMC) program. With the 2003 creation of Healthy Kids, many children enrolled in EMC became eligible for more comprehensive coverage under Healthy Kids. But no formal mechanism was established to coordinate the programs, and the potential for children to be enrolled in both Healthy Kids and EMC was created. This study examines the benefits and challenges created by dual coverage and efforts made to capture state and federal funds to support Healthy Kids.