In the first survey since the Affordable Care Act’s coverage expansions became effective, state health thoughtleaders’ perception of our state’s progress hasn’t changed much. CT again earned a C+ on health reform, and interestingly a somewhat lower C grade for effort in the latest survey. Among issue areas, CT continues to earn better marks for Medicaid, patient-centered medical homes and the health insurance exchange. The lowest marks are for health information technology, engaging consumers in policymaking, and payment reform/quality improvement. Thoughtleaders’ suggestions to improve progress are to engage consumers, smarter policymaking and leadership, and to improve communication and public education.