The Department of Health and Human Services (HHS) recently promulgated restrictions on the State Children’s Health Insurance Program (SCHIP), which insures nearly six million children by offering matching funds for states’ health care programs. Most significantly, the restrictions prohibit states from expanding SCHIP eligibility until they meet an inflexible benchmark: ninety-five percent coverage for children whose families’ income is below twice the federal poverty level (FPL). By stifling states’ efforts to expand SCHIP coverage, these new restrictions will have adverse consequences for access to health care for low-income children. And the promulgation of stricter federal requirements has implications not only for SCHIP, but for other federally-funded health programs administered by states, including Medicaid. In order to protect state health policy initiatives from these and other harmful federal restrictions, I propose a legal strategy for advocates to (1) force federal agencies to follow more democratic processes and (2) combat the traditional deference accorded to agency interpretations in the health care context.