To inform policy conversations and support state policymaker responsiveness, the Altarum Healthcare Value Hub’s 2021 Healthcare Affordability State Policy Scorecard ranks states’ performance on a broad set of policies to make healthcare more affordable and allows readers to: do a quick and easy assessment of actions their state has taken and identify actions policy makers can take to further improve. In this Health Affairs Forefront article, we outline four fundamental areas that affect healthcare affordability and how states have acted in those arenas to improve affordability for their residents.