Beginning in 2014, the ACA requires that newly established health insurance plans in the individual and small group markets, the exchanges, and Medicaid provide a minimum package of services, known as “essential health benefits” (EHB). States must consider many factors in establishing EHBs, including: aligning their EHB packages between plans in order to ensure continuity of coverage; determining the fiscal and budgetary implications for EHB selection; and addressing the health care needs of their populations. This brief highlights these key considerations as states move forward with implementation of the ACA.