Chart of state decisions related to implementation of the federal health care reform law, the Affordable Care Act (ACA). Originally created by the Center for Health Law & Economics, UMASS Medical School, and Health Care For All; updated by the BCBSMA Foundation. This document was last updated in February 2013. Please refer to Re-Forming Reform Part 2: Implementing the Affordable Care Act in Massachusetts for more information regarding ACA implementation in the Commonwealth.