In this commentary for Spotlight on Poverty, the authors address the issue that poverty often starts at birth, leading to unstable housing, schooling, and nutrition. As young adults, these children are more likely to drop out of school, have a child as a teen, and be underemployed. Taking action before the consequences of poverty accumulate is imperative. Health reform provides an opportunity for hospitals to connect poor families to insurance when a child is born. The United States can invest in poor children through social services as we invest in higher-income children through tax subsidies for homeownership and college.