Obamacare is on the march, and state policymakers must decide by 2014 how they will respond to this encroachment on state’s rights to control their own health insurance markets. The state of Utah has been on the reform path since 2005. With its system of defined contributions (as opposed to the standard defined benefits), a functioning health insurance exchange, and appropriate risk-adjustment mechanisms, Utah has given its workers the freedom to choose among many health plans with different levels of benefits, instead of remaining tied to the one-size-fits-all approach dictated by Washington. The Heritage Foundation has discerned five distinct lessons that the other 49 states can learn from Utah’s experience. The time for learning and for action is now.