South Dakota

Originally posted 8/17/23; updated as of 11/08/23

Pretty straightforward in the Mount Rushmore state. Three carriers on the individual market; around 48,000 enrollees total; requested rate changes ranging from a slight drop to a 5.9% increase. The weighted average across all three is +2.5%. No one new seems to be entering the market and none of the current ones are pulling out.

For the small group market, there are six carriers (again, no one new, no one dropping). The requested rate increases for these range from 2.5% to 10.3%, with a weighted average increase of 5.2% statewide.

Update 11/08/23: No changes to any of the preliminary filings on either market.

A reminder via Dakota News Now:

SIOUX FALLS, S.D. (Dakota News Now) - Although Medicaid expansion in the state of South Dakota doesn’t take effect for another month, the window to apply opened on Thursday. A kickoff event was held for advocates and patients to review the benefits for those who qualify.

“Today has been long overdue. No one should have to choose between bankrupting their family and getting the health coverage they need,” said Dr. Dan Johnson from the American Cancer Society.

After the hard work of gathering petition signatures and talking to voters, Medicaid expansion advocates are celebrating enrollment opening for South Dakota residents.

...Over 50,000 people will be eligible for Medicaid, as voters approved Constitutional Amendment D last November. Erik Nelson, an advocate with AARP, has had positive conversations with the state handling the logistics of enrollment.

...Even if applicants don’t have their application completed by the July 1 effective date, a plan is in place.

South Dakotans Decide Healthcare


Back in January 2021, I. noted that:

...over the past few years, the voters of some of those states have decided to take it upon themselves to force their legislators/governors to expand Medicaid anyway, via statewide ballot initiative campaigns:

South Dakota

In South Dakota, there are only 2 carriers offering individual market coverage next year. Avera has around 21,800 enrollees; Sanford has roughly 23,900. The weighted average rate increases requested are around 11.4%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.3%.

UPDATE 11/01/22Well, it looks like the individual market filings were approved as is. I'm guessing the small group carrier filings were as well, though I don't know that for sure.

South Dakota

South Dakota's 2022 rate filings are pretty straightforward. There's still just two carriers offering policies on the individual market (Avera and Sanford), while it looks like UnitedHealthcare may be dropping out of the states small group market (they have a rate filing in the SERFF database, but it doesn't show up on the federal Rate Review database, and even the SERFF filing doesn't lis any specific rate increase or decrease).

Assuming all are approved as is, residents are looking at a 1.4% rate drop on the individual market and a 4.0% increase for small group plans.

UPDATE 10/26/21: Sure enough, it looks like all rate requests have been signed off on as is.

South Dakota

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources. For South Dakota, I'm using estimates based on raw data from the South Dakota Dept. of Social Services for January 2021 and beyond.

South Dakota is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund).

South Dakota

 Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.

Here's South Dakota:

WARNING: The CDC lists ~67,000 South Dakota residents (a whopping 21.8% of the total fully vaccinated) whose county of residence is unknown; this could impact the trendline significantly.

South Dakotans Decide Healthcare


Back in January, I. noted that:

...over the past few years, the voters of some of those states have decided to take it upon themselves to force their legislators/governors to expand Medicaid anyway, via statewide ballot initiative campaigns:

The ACA was originally designed with the intention that all documented Americans living in all 50 states (+DC) earning up to at least 138% of the Federal Poverty Level (FPL) would be eligible for Medicaid. Unfortunately, the 2012 NFIB v. Sebelius ruling by the U.S. Supreme Court stated that Medicaid expansion under the ACA had to be left up to each individual state.

This meant that each state had to decide, whether by legislation, executive order (depending on the state) or ballot initiative, whether or not to expand the low-income public health program or not. Under the ACA, any state which does so will have 90% of the cost paid for by the federal government, while the state has to pony up the other 10% of the cost.

Of all the elected officials who have been aping Donald Trump's horrific COVID-19 pandemic denialism, perhaps none have been worse (at least in terms of actual policy impact) than Republican South Dakota Governor Kristi Noem.

Not only has Gov. Noem refused to take any significant action to slow the spread of COVID-19, she's openly mocked those who do and is even starring in TV ads encouraging tourism of South Dakota based on her refusal to impose any reasonable measures using federal COVID-19 relief funding...even as South Dakota has become the second worst COVID hot spot in the nation (first place? SD's neighbor to the north...North Dakota).

In response to widespread criticism, Gov. Noem today penned an Op-Ed for the Wall St. Journal in which she argues that everything is actually peachy-kean in the Mount Rushmore State: