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This case study discusses the trends in new enrollment of children in Kentucky’s Medicaid and SCHIP from 1999 to 2005. In addition, we examine the trends in retaining children in these programs. In examining these trends, we are particularly interested in their potential links to major policy changes that took place in Kentucky, especially those associated with the CKF grant. Ideally, we would examine such links through a formal impact analysis that estimates the effect of individual policy changes on the number of children enrolling or remaining in Medicaid or SCHIP. This type of analysis is not possible, however, because no state or other geographic area provides a defensible comparison group for a rigorous analysis. The case study approach, which combines exploratory data analysis with in-depth interviews with key informants, allows us to assess the potential influence that policy changes have had on new enrollments and retention.