As summarized in the This American Life segment "Who Would Win In A Fight Between A Polar Bear And An Insurance Company?," what impact did HMOs have at their height in the mid-1990s? Group of answer choices HMOs were fairly effective in holding down costs and, in the aggregate, overall health outcomes did not decline. HMOs were ineffective in holding down costs because they "dumbed down" the standard of care for primary care services, thereby harming overall health outcomes and increasing the need for specialized care. HMOs were fairly effective in holding down costs, but in the aggregate, overall health outcomes suffered. HMOs were effective in holding down costs and were extremely popular among providers and physicians until they became illegal under HIPAA of 1996