With passage of the Affordable Care Act, the stakes for children’s coverage perhaps have never been higher. Children potentially have much to gain in coverage for themselves and for their parents. However, they also have much to lose in shifting attention, and in unintended consequences of reforms focused on adults. To examine the options for keeping children’s coverage strong in future, NASHP initiated discussions with CHIP program directors. This brief highlights themes from those discussions, focusing on key considerations for children’s coverage that NASHP and most CHIP directors believe policymakers should take into account in making decisions that may affect children’s coverage.