Both Virginia and Maryland lawmakers took steps to make insurance for small businesses more affordable in their 2009 sessions. In Virginia, lawmakers passed legislation allowing health plan designs to remove most of the state's coverage mandates in a development that could decrease premiums by as much as 20 percent. In Maryland, a new law makes drastic changes to the state's standard benefit plan, permitting carriers to consider pre-existing conditions and health status in setting rates. Only eight carriers have been participating in the small-group market in Maryland with the large majority of the market controlled by CareFirst BlueCross BlueShield. Meanwhile, regional insurers are hoping the new subsidy for laid-off workers may stem membership drops related to the economic recession. CareFirst BC/BS has launched a $4 million medical home pilot project involving 11 primary-care practices in the District of Columbia, Virginia and Maryland. And an innovative program in Howard County, Maryland, that offers healthcare to the uninsured has received county funding for another year.