Our state’s Medicaid program is out of control and has been for years. Each state creates its own Medicaid program within federal guidelines, leading to variations in eligibility, covered services and provider payment rates across the country. New York’s program is one of the most generous. Every year in Albany, new treatments, new therapies and new benefits are added to the Medicaid program, further increasing costs. Access to quality health care and responsible fiscal policy are not opposing goals, we can and must achieve both.