Despite the enormous benefits Medicaid and the Children’s Health Insurance Program (CHIP) provide to Washington State’s families and economy, the Legislature is considering charging premiums to many children in these programs. The proposed premiums will wreck havoc on the lives of vulnerable children, cost the state more in the long run, and harm Washington’s economy. This report provides an overview of the important contributions Medicaid and CHIP make to the economy of and quality of life in Washington State, and the devastating impacts of premiums.