This brief examines CKF’s work in Washington State, one of only a handful of states that has achieved near-universal health insurance coverage for children. The study finds parallels between the current weak economy and Washington's economy in 2002; CKF's response at that time was to focus on mitigating the effects of policy changes that might otherwise have reduced enrollment and retention in public programs. Although the CKF project could not afford to maintain its staff after its grant ended, CKF coalition members have maintained the focus on coverage issues in the state by merging their efforts into another similarly focused coalition.