This presentation focuses on key barriers to state efforts to integrate care for dually eligible beneficiaries. These include challenges states face in enrolling dually eligible beneficiaries, keeping them enrolled in integrated products, and limited state expertise in Medicare for tasks such as designing integrated care programs and developing contracts with dual-eligible special needs plans. The presentation identifies possible policy options to address these barriers and offers options for potential further development and inclusion in MACPAC’s June 2020 report to Congress.