Stakeholders in the healthcare industry are looking at the health reform law, planning ways to minimize losses and take advantage of opportunities. In North Carolina, federal and state high risk pools will run concurrently, operated by the state. While debate about healthcare reform raged alongside recession in 2009, most commercial health plans in the Carolinas continued to show slight gains in enrollment and retained HMO profitability though not at previous rates. In North Carolina, CDHP enrollment took off, nearly doubling in a year. In South Carolina, commercials plans expanded, but they were outpaced by Medicaid MCOs. In both states, UnitedHealthcare unveiled a new value-based pilot program for small groups, covering some brand name prescription drug on low tiers. CIGNA and Humana began a partnership, allowing CIGNA to sell Humana Medicare Advantage plans, allowing employers to offer seamless coverage into retirement.