As states gear up for full implementation of the Affordable Care Act, more children than ever will be able to get health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or their states’ health insurance marketplaces. But many of these children are predicted to experience mid-year changes in eligibility (caused by shifts in household income), which could mean that they have to switch health insurance programs. When children move between health coverage programs or in and out of coverage multiple times a year—a process called “churning”—their health can suffer. States can address this problem by adopting or expanding 12-month continuous eligibility policies.