The creation of the State Children's Health Insurance Program (SCHIP) in 1997 was a landmark event in American social history. The program substantially broadened the role of public health insurance for children living near poverty, illuminating wide popular support for ensuring coverage for the most vulnerable in American society. Not since Medicare and Medicaid were established in 1965 had the Congress enacted such a large, subsidized health insurance program. Designed to provide health insurance coverage for many of our nation's low-income uninsured children, the SCHIP legislation enjoyed enthusiastic support in all quarters. Universal concern for low-income children, the availability of federal surpluses, and successful compromises converged to make this historic achievement possible.