The status of the quantum state is perhaps the most controversial issue in the foundations of quantum theory. Is it an epistemic state (representing knowledge, information, or belief) or an ontic state (a direct reflection of reality)? In the ontological models framework, quantum states correspond to probability measures over more fundamental states of reality. The quantum state is then ontic if every pair of pure states corresponds to a pair of measures that do not overlap, and is otherwise epistemic. Recently, several authors have derived theorems that aim to show that the quantum state must be ontic in this framework. Each of these theorems involve auxiliary assumptions of varying degrees of plausibility. Without such assumptions, it has been shown that models exist in which the quantum state is epistemic. However, the definition of an epistemic quantum state used in these works is extremely permissive. Only two quantum states need correspond to overlapping measures and furthermore the amount of overlap may be arbitrarily small. In order to provide an explanation of quantum phenomena such as no-cloning and the indistinguishability of pure states, the amount of overlap should be comparable to the inner product of the quantum states. In this talk, I review the debate over the interpretation of quantum states and explain how the overlap of probability measures can be bounded using proofs of the Kochen-Specker theorem. In particular, I exhibit a family of states in d-dimensional Hilbert space for which the ratio of overlap to inner product must be ≤ de-cd for some positive constant c, which severely constrains the epistemic interpretation of quantum states.