Like the last two months, November’s CT’s Health Reform Dashboard has changed little. Growing and understandable mistrust remains at the core of problems in CT. Medicaid policy development and implementation is still mired in mistrust, incomprehensible and misleading consumer “notices”, rushing ahead without data, quality problems, and a lack of transparency while state officials refuse to answer questions. CT’s Health IT quagmire gets worse. The state budget is terrible causing thousands more working parents to lose coverage. At the federal level, ACA protections and supports are in jeopardy, Medicaid is not secure, and the budget is also terrible. The Health Care Cabinet workgroups continue digging into our work to control drug costs in CT, but we need to up the game and be sure reforms address the total cost of medications to the entire system. Consumers understand that we pay the entire bill – premiums, taxes, and lost wages – not just out-of-pocket costs. Saving in one area just adds costs in another – and we end up paying more in the end anyway.