Which legislation was mainly responsible for the decline of Medicare enrollments in managed care after a rise in enrollments?

Question

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The Balanced Budget Act of 1997 introduced significant reductions in Medicare reimbursement rates to managed care plans, which led to many plans dropping out of the program or reducing benefits offered. This resulted in a decline in Medicare enrollments in managed care after an initial rise.

Which Legislation Was Mainly Responsible for the Decline of Medicare