The most frequent reason that uninsured adults who visited a health insurance marketplace gave for not enrolling in marketplace coverage was unaffordability, even with subsidies. This report examines how several states appeared to overcome this obstacle. For example, Minnesota uses a Medicaid waiver to provide more affordable coverage outside the marketplace to consumers with incomes up to 200 percent of the federal poverty level, planning to transition to the Basic Health Program in 2015. Vermont supplements federal subsidies inside the marketplace to improve affordability for consumers with incomes up to 300 percent of poverty.