A new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services is the first study to gauge the impact of state restrictions on the roll-out of the Affordable Care Act (ACA). Findings from the study indicate that community health centers across the country are engaged in an intensive effort to find and enroll eligible and uninsured patients and community residents. At the same time, the study found that health centers working in restrictive states are hampered in their outreach and enrollment efforts, and are significantly less optimistic about the impact of health reform on their communities.