The Balanced Budget Act of 1997 established the State Children's Health Insurance Program (CHIP) under a new Title XXI of the Social Security Act. CHIP builds on Medicaid by providing health care coverage to low-income, uninsured children in families with incomes above applicable Medicaid income standards. The latest official numbers show that CHIP enrolment reached a total of nearly 7.4 million children and nearly 335,000 adults in FY2008. In FY2008, federal CHIP spending totalled $7.0 billion, with states' projected spending expected to equal $7.9 billion in FY2009. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA)was first passed in the House on January 14, 2009, and an amended version was passed in the Senate on January 29, 2009. This book examines the history and background the CHIPRA with a focus on the provisions included in the law.