Commercial health insurers in the Indiana-Kentucky-Ohio region have experienced declining enrollment due to the economic effects of employers dropping or cutting workplace-sponsored coverage. But insurers who hold a large percentage of their books in public-employee groups, like state employee plans, have emerged as the enrollment leaders in their states. Medicaid health plans in Indiana and Ohio have now had several months to learn to live with a prescription drug carve-out. They're starting to see some disruptions in care, and would like their respective states carve pharmacy back in. States might not be in any hurry to do that, however, since the biggest argument in favor of a carve-out – that the better rebates help states balance tight budgets – remains in full force. Medication therapy management programs have also started to show some acceptance in commercial health plans. Anthem Blue Cross and Blue Shield has just completed such a program in the Cincinnati market, and would like to begin offering it to other employers, and replicate the program in other WellPoint state markets. UnitedHealthcare has also employed some medication therapy management precepts in a new diabetes control program.