This brief summarizes key findings gleaned from site visits to states where IAC has made multiyear "Finish Line" grants. These findings describe the importance of persistence, flexibility, creativity, and commitment to conducting effective states-based advocacy as well as building strong, broad-based coalitions including grassroots and state-level stakeholders. While acknowledging that much work remains, the brief cites important gains in children’s coverage since the IAC efforts began, despite the economic downturn.