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Horizon Blue Cross Blue Shield's planned conversion to for-profit status stands a markedly better chance this time, as it would raise $1 billion or more that New Jersey could use to launch proposed healthcare reforms. The Medicare landscape is already shifting in response to Congressional action against no-network private fee-for-service Medicare plans, and TriState will be a major battleground as plans try to pick up market share. Connecticut has stumbled in its attempt to combine its Medicaid program with its health plan for the uninsured, but all three states are working with changes in insurance regulation and various reforms designed to extend coverage.

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