The Affordable Care Act includes numerous consumer protections that took effect on September 23, 2010. This issue brief examines new state action on a subset of these "early market reforms." The analysis finds that 49 states and the District of Columbia have passed new legislation, issued a new regulation, issued new subregulatory guidance, or are actively reviewing insurer policy forms for compliance with these protections. These findings suggest that states have required or encouraged compliance with the early market reforms, and that efforts to understand how states are responding cannot focus on legislative action alone. The findings also raise important questions regarding how states may implement the Affordable Care Act’s broader 2014 market reforms, and suggest the need for continued tracking of state action.