This report provides an early look at state efforts to prepare for health reform, examining the experiences to date in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington).

The report finds that the state political environment and expected leadership transitions create uncertainties and are already factoring into state strategies on health reform implementation. State leaders dealing with an aging workforce, hiring constraints, and the toll from the recession also see a need for additional staff and outside contractors to help with designing insurance exchanges, handling expanded enrollment for Medicaid and state exchanges and updating eligibility systems in the timeframe required under the reform law.

The report was released at a Sept. 30, 2010 briefing on state Medicaid programs, the recession and health reform. It was authored by researchers at the Kaiser Family Foundation and the Center for State and Local Government Excellence.

Report (.pdf)

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