Commercial enrollment has decreased in Indiana in recent cycles. The commercial enrollment is expected to increase going forward with the opening of the economy as COVID-19 subsides. US Health Life joined the state's health insurance exchange in 2022 to bring the total number of carriers to four. Indiana awarded contracts for its Managed Medicaid program, and all the incumbent insurers have retained their deals. Indiana continues to see an increase in zero dollar Medicare Advantage plans, which is a positive news for Pharma.