One challenge states face in implementing the Affordable Care Act is smoothing transitions for individuals who may churn between Medicaid and health insurance exchanges. Many people who will become eligible for coverage already interact with safety net providers. This report explores potential roles safety net providers could play in bridging gaps in coverage and care between Medicaid and exchanges. The report was made possible through a cooperative agreement with the Health Resources and Services Administration. A companion webinar, Potential Roles for Safety Net Providers in Supporting Continuity Across Medicaid and Health Insurance Exchanges, presents findings from the report and related perspectives from state and local officials.