All US states and the District of Columbia, except Arizona, have begun to implement the Affordable Care Act, a report by a non-profit group said. The report -- Implementing the Affordable Care Act: State Action on Early Market Reforms, by Katie Keith, Kevin W. Lucia and Sabrina Corlette of the Georgetown University Health Policy Institute\'s Center on Health Insurance Reforms -- assessed the action of the states on 10 early reforms, including those known collectively as the Patients\' Bill of Rights, that went into effect in September 2010. The researchers found between Jan. 1, 2010, and Jan. 1, 2012, 23 states and the District of Columbia had taken new legislative or regulatory action on at least one of the reforms, and an additional 26 states had taken other action to promote compliance with the reforms, such as issuing bulletins to insurers. The report also found the states approved legislative or regulatory action including: Expanding dependent coverage for young adults up to age 26. Prohibiting lifetime limits on health benefits. Phasing out annual dollar limits on health benefits. Prohibiting preexisting condition exclusions for children under age 19. Prohibiting cancelling insurance. Covering preventive services without cost-sharing. Expanding coverage of emergency services. Allowing choice of primary care provider. Allowing choice of pediatrician. Allowing access to obstetricians and gynecologists without a referral. \"In just a year and a half since these early reforms took effect, nearly all states have moved ahead on the new coverage options and consumer protections now available to their residents under the Affordable Care Act,\" said Sara Collins, vice president for Affordable Health Insurance at The Commonwealth Fund, said in a statement.