NAMD released a statement requesting federal policymakers’ consideration of key statutory flexibilities for the Medicaid program as part of overall health care reform efforts. The statement articulates Medicaid’s successes in recent years, but also situates Medicaid as one payer among many within the wider health care system. It notes that current reform conversations envision a limit on federal contributions to Medicaid paired with regulatory flexibility. Regulatory flexibility, while welcome and necessary, is not sufficient to ensure the program’s success in a resource-constrained environment. Therefore, statutory changes granting states the tools to directly address core cost drivers within the health care system are necessary.