States have pursued different options under the Affordable Care Act. These regional briefs graphically display states’ decisions on implementation of the health insurance exchanges – marketplaces for purchase of health insurance and eligibility determination for federal subsidies to make that insurance affordable. A majority of states (26) defaulted to federal operation of the exchanges. The briefs also display states’ decisions on expanding Medicaid eligibility to 138 percent of the federal poverty level and the extent to which persons potentially eligible will qualify for Medicaid health insurance on January 1, 2014. To date, 24 states are moving forward with Medicaid expansion.