More than eight of 10 leaders in health and health care policy (82%) believe states should be allowed to implement key provisions of the Affordable Care Act early with full federal support, ahead of the timeline outlined in the law. These provisions include expanding Medicaid eligibility to cover more low-income families and creating insurance exchanges with premium subsidies. Findings are from the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, which asked respondents about the relative authority states and the federal government should have in implementing health care reform. Also read commentaries by former Vermont governor Jim Douglas and Illinois Department of Insurance director Michael McRaith.