I will describe the effects of non-trivial initial quantum states for inflationary fluctuations within the context of the effective field theory for inflation. We find that besides giving rise to large non-Gaussianities from inflation, general initial states can also have interesting implications for the consistency relation of the bispectrum. In addition, they leave a distinct observable signature on the scale-dependence of the bias of dark matter halos. I will also discuss constraints on the initial state from current large scale structure data, including luminous red galaxies and quasars in the Sloan Digital Sky Survey sample.