Connecticut health care thought leaders give our state a C on health reform again this winter; down from a C+ earlier this year. Connecticut maintained our C+ for effort in this survey. Among issue areas only Medicaid improved again. Connecticut lost ground on the health insurance exchange, health insurance market reform, and public education. The overwhelming suggestions to improve progress are to engage consumers in policymaking (on every survey in the last year), improve the policymaking process, especially transparency, work on affordability and improve the CT Health Insurance Exchange.