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Unable to reach a compromise between the House and Senate, Florida's state Legislature did not expand Medicaid Reform, which requires beneficiaries in certain counties elect to join an HMO or a Provider-Sponsored Network. Instead, these 250,000 beneficiaries will remain in MediPass, the state's primary care case management program. HMOs didn't lose completely though because as Florida's Medicaid rolls have swelled, HMOs – which administer the drug benefit – have proven successful at recruiting beneficiaries to join HMOs voluntarily. Although the Medicaid HMO is adding enrollment, the commercial market continues to suffer because of the economy. Commercial HMO enrollment fell in 2009 for nearly every major carrier with areas such as Tampa and south Florida experiencing the most notable drops. Health plans say employers are looking to reduce costs, but churn between plans may be down for those employers not wanting to face experience rating for the premiums at new carriers. With unemployment stabilizing and likely falling in coming months, the resulting uptake in health plans may take at least six months or longer to materialize.

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