Since the Academy held its first state legislative strategies meeting in June, the effort to duplicate the national Patient Access to Specialty Care Coalition at the state level has been very successful. To date, there are active coalitions in California, Illinois, New York, Texas, and Washington. Other states in the process of developing coalitions include Alabama, Colorado, Indiana, Iowa, Massachusetts, New York, North Carolina, Oregon, and Pennsylvania. The Illinois Coalition for Patient Access and Choice, which is being used as a model for other states, has expanded its focus to include patient access to primary and specialty care physicians, in plan and out of plan. The coalition is working closely with the Illinois State Medical Society to develop and promote the passage of legislation which protects patient access.