Last month Connecticut’s State Innovation Model (SIM) planning group, working for most of the year, solicited public comment for the first time. SIM is the administration’s plan, based on federal grant provisions, to radically transform Connecticut’s health system – payment and care delivery. The federal grant requires the plan to cover at least 80% of state residents within five years – Medicare, Medicaid, employer-sponsored, and private coverage. SIM received 84 comments from a broad range of stakeholders; the majority were critical of the plan. Top themes in the comments were concerns about excluding key stakeholders, incentives to deny necessary care, excluding consumers and advocates, a lack of transparency and downside risk that could jeopardize recent progress improving Medicaid.