This OCUFA study presents the results of a decade of fiscally motivated tuition increases and the lack of a coherent tuition fee policy in Ontario. The report cautions against a narrow framing of tuition policy, warning that embracing past practices of either annual incremental fee increases or radical expansion of fee deregulation will have a negative impact on access. The report laments in particular the situation of middle- and lower-income families, who are struggling after a decade of rising tuition fees.