CT’s September Health Reform Dashboard update is about the same as last month. Medicaid policy development and implementation is still mired in mistrust, rushing ahead without data, quality problems, and a lack of transparency while state officials refuse to answer questions. Thankfully physicians and others are taking the reins and building a badly needed health information exchange, because state government has been unable to get it done. The state budget remains dreary and while ACA repeal and replace efforts are cooling off, serious risks remain. In good news, the Health Care Cabinet workgroups continue digging into our work to control drug costs in CT. Growing mistrust remains at the core of problems in CT.