Even though the Minnesota Legislature will never allow this desperately needed, commonsense solution, the federal government can bypass Minnesota’s legislative recalcitrance. The federal government just needs to withdraw or modify Minnesota’s 1115 Medicaid waiver. It is this waiver from traditional federal Medicaid law that allows the use of private insurance companies as middlemen in our Medicaid program. It is this waiver that allows our Medicaid patients to be forced into managed care programs they don’t want to be in. It is this waiver that allows our experimental, pilot or demonstration project in Minnesota Medicaid, which has been ongoing for more than 39 years, to continue to the detriment of patients and taxpayers alike. That is a long time with no benefit to anyone except the insurance middlemen. Fortunately, this could all change if the federal government withdraws the 1115 waiver or, at the very least, gives Medicaid patients the freedom to choose traditional fee-for-service Medicaid. Since the Minnesota Legislature won’t do this, the federal government should, thereby achieving both cost savings and better-quality care.