Passage of the state's new Cover Florida program is likely to put some of the 3.8 million uninsured residents into health insurance, but critics question how much help the low-premium/limited benefits plan can provide given the wide variety of low-cost designs already available on the market. Medicare Advantage insurers in Miami/Dade County once again will receive the highest reimbursement increase from the federal government in the United States for 2009. Florida's largest health insurers failed to increase their premiums enough in 2007 to keep pace with rising prescription drug costs. Lawmakers in the Sunshine State refused to extend the five-county pilot program for Medicaid reform that allows health plans and provider-sponsored networks to design their own Medicaid benefit packages. And health plans are using a variety of strategies to manage the high costs of specialty drugs.