This report that outlines the Granite State's "wait and see" approach to implementing the Affordable Care Act (ACA). The state's cost-effective health insurance exchange - which delegated operation of the web site to federal officials - performed well during the first ACA open enrollment period. The Democratic governor and Republican legislative leaders also adopted a Medicaid expansion plan that reflects the state's traditional preference for limited government and local control. New Hampshire's experience demonstrates even in states with divided party control, meaningful bipartisan health care reform is still possible. The New Hampshire report is part of a series of state and regional studies examining the rollout of the ACA. The national field network, with 36 states and 62 researchers, is led by the Nelson A. Rockefeller Institute of Government of the State University of New York, the Brookings Institution and the Fels Institute of Government at the University of Pennsylvania. The New Hampshire report was prepared by Robert Hackey, professor of Health Policy and Management at Providence College; Todd Olszewski, assistant professor of Health Policy and Management at Providence College; and Danielle Waldron, a Providence College senior.