This edition of WICHE Insights reviews the results of the Western Interstate Commission for Higher Education's (WICHE) annual survey of tuition and fees at public postsecondary institutions in the West, along with trends in state appropriations and state financial aid. WICHE administered its tuition and fees survey in the summer and fall of 2018 to state higher education executive offices, system offices, or institutions in its 16 member states and territories--Alaska, Arizona, California, Colorado, Hawai'i, Idaho, Montana, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming, and WICHE's Pacific Islands member (the Commonwealth of the Northern Mariana Islands and Guam). Overall in the region, fiscal trends present a positive outlook as tuition and fees have stabilized over the past five years and state support for higher education has recovered steadily. However, tuition and fees have increased at a significantly higher rate than income over the past two decades, creating a barrier for access to higher education, particularly for low-income students.