Healthy Indiana Plan, which was created in 2007, is experiencing one of the fastest launches of any Medicaid-expansion program in the country. By mid-2008, the program had more than 14,000 Hoosiers enrolled and another 7,400 applications pending; it offers medical and pharmacy benefits along with a medical savings account for those with incomes up to 200 percent of the federal poverty level. Meanwhile, Ohio's Medicaid managed care program continued to unravel as three of the eight plans serving beneficiaries have decided to drop out because reimbursement rates are not covering medical costs. Hospitals and health plans are at odds over how hospitals are reimbursed for Medicaid services. Aetna has taken the lead in Medicare Advantage enrollment in Ohio, and nearly all of it is from the company's private fee-for-service plan-a product line that has an uncertain future. Nearly all HMOs in Kentucky, Ohio and Indiana posted healthy profit margins in 2007, according to the latest data from HealthLeaders-InterStudy. In the Indiana commercial market, approximately 80,000 members of the M-Plan HMO are now booked by Anthem Blue Cross and Blue Shield in Indiana, and a health plan in northern Indiana, Physicians Health Plan, has been selling a suite of individual products called Indigo.