One year into implementation, the Affordable Care Act (ACA) has broadened Medicaid’s base of coverage for the low-income population and accelerated state efforts to move from outdated, paper-driven enrollment processes to a new modernized enrollment experience. Given the fast-paced policy environment leading up to when the ACA’s key coverage provisions went into effect on January 1, 2014, an abbreviated report based on publicly available data was published last year. This year, we resumed conducting interviews with key state Medicaid and CHIP policy experts (to whom we are immensely grateful) to provide a broader look at ACA implementation. The policy environment continues to rapidly change and improve on a week-to-week basis, making it tricky to capture a complete, up-to-the-minute picture of certain swiftly evolving processes such as renewals, verification using data sources, and account transfers between coverage sources. Nonetheless, the 2015 survey creates a new baseline for measuring ongoing progress and improvements in Medicaid and CHIP in future years as states continue to modernize their programs.