Arkansas was the first state to choose the “private option” for Medicaid expansion—using commercial insurance plans to cover newly eligible adults. As part of a multiyear Commonwealth Fund–supported study on the impact of the Affordable Care Act’s Medicaid expansion in selected states, Bethany Maylone and Benjamin D. Sommers, M.D., of the Harvard T. H. Chan School of Public Health explore the evidence to date on Arkansas’s waiver program, which the authors say has produced significant benefits for the state’s low-income residents.