For the sake of competition in Maryland’s Obamacare marketplace — particularly for those who buy insurance as individuals, not through their employers — Evergreen Health needs to survive. CareFirst BlueCross BlueShield had 80 percent of Maryland’s individual insurance market in 2014, according to the Kaiser Family Foundation, up from 74 percent three years before. Evergreen, with nearly 40,000 members and growing fast, is expanding in the state at a time when other carriers are pulling back. Though still relatively small, it provides another option for consumers and puts pressure on the dominant carrier to innovate and contain costs.

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