By Louise Norris
February 2, 2014
3,194 people had enrolled in private plans in the South Dakota exchange by December 28 – up from 2,500 just four days earlier. Nearly 1,500 applicants were eligible for Medicaid under the existing rules. South Dakota has not expanded Medicaid yet, although at the end of January, Governor Dennis Daugaard submitted a proposal to HHS for a waiver that would allow the state to expand Medicaid to people with incomes up to 100% of poverty level. The ACA calls for Medicaid expansion to 138% of poverty level, but people with incomes between 100% and 138% of poverty are eligible for subsidies in the exchange, while those with incomes below 100% are not eligible for premium assistance. It’s not clear yet whether HHS will grant the waiver.
Three insurers are offering policies through the marketplace in South Dakota: Avera Health Plans, Sanford Health Plan, and DAKOTACARE. The three companies are offering a total of 38 options for individuals and families. The large majority of the enrollments between October 1 and December 24 were with Avera (1,889). Sanford reported 629 enrollees by December 24, while DAKOTACARE – which is focusing more on the small group market – had fewer than 50 enrollees.
Wellmark Blue Cross and Blue Shield plans to join the South Dakota marketplace for the 2015 open enrollment period, which begins on November 15, 2014.
On November 26, the state announced that it would allow carriers to extend existing policies per President Obama’s suggestion that non-compliant plans be allowed to remain in effect for one more year. Sanford and DAKOTACARE have both opted to allow existing policies to be renewed into 2014, giving current insureds another option to compare with the new 2014 plans.
According to a report released by the U.S. Department of Health and Human Services (HHS), the average cost for a bronze plan —the lowest-cost option — in South Dakota is $298 a month. The national average for a bronze policy is $249 a month.
Gov. Daugaard announced in late September 2012 that HHS would be running the state’s exchange, citing the high cost — estimated at $6.3 to $7.7 million — for ongoing operation of the exchange.
The state is not playing any role in promoting the new health insurance options or educating consumers about the marketplace. That decision leaves outreach efforts to the insurers and federally funded “navigators.” Navigators are affiliated with established community outreach and advocacy groups, and they are trained to help consumers understand and use the new online marketplace.
According to HHS, more than 92,000 South Dakotans (13 percent of the state population) are uninsured and eligible to use the marketplace.
Open enrollment for coverage in 2014 runs from Oct. 1, 2013 through March 31, 2014.
State Exchange Profile: South Dakota
The Henry J. Kaiser Family Foundation overview of South Dakota’s progress toward creating a state health insurance exchange.
Let your South Dakota governor and legislators know how you feel about the state’s proposed health insurance exchange.South Dakota Governor Dennis Daugaard