Making sure that women of reproductive age are healthy before and between pregnancies increases their chances of having healthy pregnancies and remaining healthy throughout their lives. The Maternal and Child Health (MCH) Program at the Colorado Department of Public Health and Environment strives to improve preconception health among women and men of reproductive age with a focus on intended pregnancy and healthy weight. Interviews revealed that states are using innovative strategies and partnering with other programs, agencies and collaborative groups to maximize tight budgets and promote preconception health.