Families face significant challenges in caring for their CSHCN. For many families, one of these challenges is the economic impact of inadequate health care coverage. Families must make hard choices about how to spend limited salaries and then make substantial sacrifices in other domains to ensure adequate care for their children. But for other families, the resources to pay for care are simply not there. Children and youths who are uninsured or whose insurance does not pay for critical components of care may experience adverse outcomes in relation to health, development, and capacity to function because their families just cannot afford to pay for vitally needed care.