This paper examines the impact that the lack of health insurance has on children and their families. A random sample of families of children who were newly enrolled in a children's health insurance program were interviewed by telephone and asked about the children's health status, the amount of unmet need and delayed care for a number of services, consequences of unmet need and delayed care, usual activities, and the effect on the lack of health insurance. Data were analyzed by using both quantitative and qualitative methods. We found that uninsured children had experienced considerable unmet need and delayed care that increased as the time without insurance increased. The parents reported some adverse consequences. The children were also found to be limited in the extent to which they could participate in various activities specifically because they lacked health insurance. Finally, the parents reported considerable stress and worry associated with their children's lack of coverage. We conclude that being without health insurance has broad consequences for America's children.