This report summarizes and updates a study prepared by CBC, "Confronting the Tradeoffs in Medicaid Cost Containment," released in 2004. It makes the case that it is possible to lower Medicaid expenditures by about $5.8 billion annually, without reducing the program’s effectiveness in helping low-income New Yorkers obtain needed care. These significant savings are feasible by addressing the three main areas where New York’s program differs drastically from those of other states. This report describes these differences and makes three recommendations to bring New York’s program more in line with national norms.