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Through its full carve-out of the pharmacy benefit for Medicaid and CHIP, the Texas Health & Human Services Commission has saved billions of dollars through drug rebates. Texas' public-sector retirement systems have made changes in the past to better deal with shortfalls, but continually high hospital expense trends for the Employees Retirement System of Texas could mean changes to benefits for the next fiscal year. UniCare's departure from the market surprised some, but its membership has easily transferred to the WellPoint subsidiary's insurer of choice, Blue Cross and Blue Shield of Texas. Medicare Advantage Special Needs Plans have dug down to reach the state's dual eligible population.

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