Florida Medicare Advantage plans are reacting to reduced reimbursements by scaling back benefits and raising costs to their HMO members for 2010. The change, which comes as the federal government is cutting federal payments to plans by about 5 percent, is being felt as some carriers increased copays while others moved drugs to higher tiers. Elsewhere, the Florida HMO market continued to lose members in the first half of 2009 because of the recession, but insurers kept premium increases at a minimum, boosting profits through cost containment. The South Florida market is being partly reshaped as insurers battle for the sizable public school system contracts, which represent more than 100,000 combined lives in three counties. Medicaid enrollment continues to grow and a new analysis by the University of Florida showed the financial savings achievable by managed Medicaid. This report could shape the controversial Medicaid Reform program and comes as Mike Fernandez – former owner of PHP and CarePlus – is reentering the HMO market with a Medicaid HMO called SimplyHealthcare.