Many low-income, uninsured children have access to employer coverage but are not enrolled, presumably because their parents cannot afford to enroll them. One strategy for increasing the enrollment of low-income children is to help parents pay the employee contribution required for family enrollment in their employment-based health insurance. This strategy is known as "premium assistance."

Premium assistance offers many potential benefits as a means for providing coverage to low-income children; but at the same time, several practical difficulties in realizing that potential remain.