Evaluating the intensity of each state's efforts to implement the recent expansions in Medicaid eligibility for pregnant women and infants was the goal of this study. The project surveyed state Medicaid and Maternal and Child Health (MCH) Directors and other key officials in each state on a variety of factors, including adoption of eligibility levels, outreach efforts, facilitation of the enrollment process, provider reimbursement rates, level of services provided, and coordination between the Medicaid and MCH Departments. The information was used to categorize each state according to the "aggressiveness" of its implementation efforts, and case studies were conducted to explore the various factors influencing "aggressive" or "nonaggressive" behavior.