This brief draws on the experiences of five states-Colorado, Kansas, Minnesota, New York and Oregonthat received federal State Health Access Program (SHAP) grant funding to expand health coverage using approaches that included community-based outreach and improvements to Medicaid/CHIP eligibility and enrollment processes. We describe the best practices that these states shared with regards to activities related to outreach, streamlining application and enrollment processes, and modernizing eligibility determination systems, and consider the implications of these practices for implementing the Affordable Care Act (ACA).