The health-care debate has centered on Washington but its implementation will happen everywhere else. Where you live will have a great deal to do with the shape of the health care that is available to you, says a new report in the Washington Post. In whatever form the new health-care reform arrives, state officials will have numerous decisions to make. "The fact is that state programs are going to look different," said one policy expert. Central to this problem is the promise of a "trigger," which is supported by Maine Sen. Olympia Snowe, allowing a public-option to exist only in states where private insurers have failed to offer policies that are broadly affordable.