States are leaders in health reform and have been working diligently to implement innovative practices and policies to improve health care for their citizens by developing more coordinated and efficient systems. Governors are implementing new approaches to addressing health care challenges and rising costs by improving access to care and reforming delivery systems.

States are also called upon to play a significant role in federal health reform implementation as part of the Patient Protection and Affordable Care Act, signed into law on March 23, 2010, which includes a range of state requirements and options. Governors and other state officials need clear information, guidance and tools to determine the best course for their states.