The coming months will be important in determining the framework for children’s health insurance coverage. The future availability of tax credits for marketplace coverage under the Affordable Care Act (ACA) in 34 states is in the hands of the Supreme Court, while the fate of the Children’s Health Insurance Program (CHIP) and future Medicaid coverage for children rests with Congress. This brief projects how these decisions would affect the number of uninsured children. Up to 3.3 million children could become uninsured if states scale back coverage of Medicaid for children and tax credits are not available in 34 states.