The following snapshots describe how three states are organizing to implement reform. Colorado, preparing for a change in state leadership in January, established an inter-agency board to develop a roadmap for the next administration, focusing primarily on establishing their high-risk pool, educating consumers about reform, and designing the insurance exchange. Pennsylvania established a reform implementation committee and an advisory committee overseen by an office that has been dedicated to state-level reform since 2003. Virginia, whose administration has been very vocal in opposing federal health care reform, has nonetheless established an initiative that will facilitate implementation of federal reform requirements, and develop state-level strategies that focus on the state's key health system problems.