As focus shifts away from Congressional health reform activity, states are gearing up to act on the many PPACA provisions requiring their attention. Among other things, states will be looking to implement insurance market reforms; establish insurance exchanges; comply with new Medicaid eligibility, benefits, reimbursement and other policy revisions; and pursue funding opportunities under a variety of health policy grants and demonstration projects. A number of states already have created new state agencies or appointed working groups to meet these PPACA responsibilities. For instance, Colorado Governor Bill Ritter has named a Director of Health Reform Implementation and established an new Interagency Health Reform Implementing Board, and Maryland Governor Martin O’Malley has signed an executive order creating the Maryland Health Care Reform Coordinating Council. Michigan Governor Jennifer Granholm has established a Health Insurance Reform Coordinating Council and centralized health reform web site for state residents. Likewise, Wisconsin Governor Jim Doyle has established a state Office of Health Care Reform, along with a new website with information about reform implementation. State health reform implementation activities can be expected to accelerate in the coming weeks, particularly to address Medicaid and insurance market provisions with 2010 effective dates.