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Maximizing health insurance coverage for children under the ACA will require addressing the complex scenarios that prevent some children from obtaining or retaining coverage. These scenarios include situations where children are eligible for Medicaid or CHIP but their parents are not, as well as those where children are living without at least one of their parents. We provide national estimates of the number of children in these complex coverage scenarios and find that children facing at least one complex scenario are more likely to be uninsured than other children. In addition to national estimates, we present state-level estimates for California, New York, and Texas.