Reader Suzanne R. Schlattman ("Ryan budget would hurt Maryland," May 9) writes, "we here in Maryland … know far better" how to run the state's Medicaid program. I couldn't agree more. So why does she oppose the reforms that passed the U.S. House, which would give Maryland officials unprecedented flexibility to run their program? Could it be because those reforms would also require Marylanders to pay for more of their own bright ideas?

Michael F. Cannon, Washington

The writer is director of health policy studies for the Cato Institute.