Medicaid and the Children’s Health Insurance (CHIP) Programs are the primary insurers of low-income children and special populations across the lifespan. In recent years their combined enrollment exceeded 40 million lives and will grow even further with the expansion of the program under the Affordable Care Act (ACA). They are administered and funded through a Federal and State partnership, and on average represent the largest portion of total state spending. Each state designs and administers its own version of Medicaid under broad federal rules. The Social Security Administration’s (SSA) Supplemental Security Income program (SSI) provides cash assistance for eligible aged, blind, and disabled individuals with limited financial means. Most states offer additional supplements to certain groups or caregories of individuals on SSI. Since Federal requirements apply in all three programs, understanding these requirements and State options are critical to management of both quality and cost of these health programs.