Part C of the Individuals with Disabilities Education Act allows states to create family-centered developmental services for infants and toddlers (birth-3 yrs) with delays. Part C Early Intervention (EI) programs have grown enormously in size and cost since becoming operational in 1994. In this article, the author describes strategies that states have taken to reduce EI costs, including creating eligibility restrictions, shifting costs to the health care system, charging parent fees, and enhancing insurance collection. A review of these strategies suggests that only enhanced insurance collection is free of unintended consequences, including loss of services to children in need, increased long-term expenditures, and a disproportionate impact on low-income families.