A commentary by Leona Cuttler and Genevieve Kenney discusses the structure of state SCHIP programs, the programs importance in increasing childrens access to care, and future challenges SCHIP faces. Topics covered include a comparison of SCHIP and Medicaid program structure and financing, how SCHIP varies among states, and issues surrounding the federal reauthorization of the program, including the level of federal funding, eligibility standards, and the allotment and redistribution of federal dollars to states. Archives of Pediatric and Adolescent Medicine 161:7 (July 2007)