They looked at how long it took late-expanding states (those that expanded eligibility after the initial implementation of ACA reforms in January 2014) to start enrollment. Though the length of time from state authorization (legislation or executive order) to enrollment varied considerably across states, once a state secured federal approval, some states began implementation very quickly.  Maine’s governor signed an executive order to implement Medicaid expansion on January 3, 2019 (her first day in office), and enrollment began just a week later. The governor of Indiana and the federal government agreed to an alternate Medicaid expansion plan on January 27, 2015, and enrollment began on February 1, 2015. Alaska’s governor used executive authority to expand Medicaid eligibility, announcing it on July 16, 2015; the expansion was implemented a month and a half later on September 1. Though these fast turnarounds were not typical of late expansion states, they demonstrate an ability to implement these programs expeditiously.