This survey of Medicaid and CHIP agencies in all 50 states and DC finds that the effective Medicaid eligibility levels are generally higher than commonly believed because most state Medicaid programs disregard some portion of family income in determining eligibility. By contrast, standard CHIP provisions generally do not use disregards in establishing eligibility. State variation is also larger than generally thought. The authors cite the need for policymakers to more closely examine the use of income disregards and to consider the simplicity and consistency of rules as they establish Medicaid and CHIP eligibility criteria.