Many young children have health, developmental or behavioral problems that are not identified before entering kindergarten, preventing them from receiving early intervention services. Large gaps in early identification exist in Medicaid, the nation’s largest health insurance program for children, in which eligible children are entitled to regular screenings. This brief breaks down the shortfalls in receipt of developmental screenings into: not all eligible children are enrolled in Medicaid/CHIP; not all enrollees see a health care provider; and not all providers have the appropriate skills. To address these problems, states can take a number of steps within the Medicaid/CHIP policy environment.