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 the COVID-19 impact faded. US Health Life joined the state’s health insurance exchange in 2022, Cigna in 2023, and Aetna in 2024. 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.