This document discusses states' perspectives on implementing expanded Medicaid eligibility and the Modified Adjusted Gross Income (MAGI) methodology under the Affordable Care Act. It outlines changes to Medicaid eligibility criteria including expanding coverage to 133% of the federal poverty level, using MAGI to determine eligibility, and establishing a coordinated eligibility system across insurance programs. The document also summarizes state challenges with implementation and implications of the changes in further delinking Medicaid from traditional welfare programs.