South Dakota may join 30 other states in expanding its Medicaid program if federal officials approve a plan Gov. Dennis Daugaard is set to outline to the nation’s top health and human services administrator in Washington on Tuesday.
The Republican governor is meeting with Health and Human Services Secretary Sylvia Burwell to explain the plan, and the federal government has so far been more open to discussions than in the past, said Tony Venhuizen, chief of staff to Daugaard. The proposal, which is in its early stages, would make about 48,500 South Dakota residents newly eligible for the program.
The twist this time is that the Indian Health Service, which provides healthcare coverage for around 2 million Native Americans nationally, would be involved:
A few weeks ago, I crunched the (minimal) enrollment/rate numbers for South Dakota and came up with a fairly ugly weighted average rate hike of 27.4% (ouch). Being such a small state & population, there are only 5 insurance companies total offering individual policies either or off the exchange: Avera, Sanford, Welmark, Celtic and SD State Medical Holding, otherwise known as "DAKOTACARE" for some reason (and no, I refuse to capitalize the whole thing in the headline).
This evening Louise Norris informed me that DAKOTACARE has made 2 rather startling changes of plan: First, they're dropping off of the ACA exchange and will only be selling policies off-exchange...and instead of their previously-requested 18-20% rate hike, they've suddenly decided that they have to jack up rates an eyebrow-raising 63% next year.
In an election where people like me are practically begging Democratic candidates in blue states to campaign on the Affordable Care Act, this is a jaw-dropping development.
South Dakota's Senate race normally would be considered a yawner. While the state does have a history of electing the moderate Democrats from time to time, it's pretty red for the most part, and no one was expecting Democrat Rick Weiland to have much of a chance against former Republican Governor Mike Rounds.
However, in an interesting development, independent candidate Larry Pressler has jumped into 2nd place in a recent poll. The thing is, Pressler isn't some no-name small timer; he's already a former U.S. Senator, serving for 3 terms before losing to Democrat Tim Johnson in 1996.
With Johnson retiring, his seat is open, and Pressler wants it back, so he's jumped back into the game. Here's the thing, though: Pressler used to be a Republican. In South Dakota.
Unless Illinois acts quickly, it will leave hundreds of millions of federal dollars on the table that would go toward building its own health insurance marketplace, potentially upping the cost of coverage for nearly 170,000 Illinois residents. State lawmakers, unable to break a years-long standoff, have not passed a law authorizing a state-based exchange, the marketplaces created under the Affordable Care Act that allow consumers to compare and buy health coverage, often with the help of federal tax credits. As a result, Illinois was one of 36 states that relied on the federal government to host its marketplace on HealthCare.gov, the website that survived a disastrous launch late last year to enroll about 217,000 Illinoisans, 77 percent of whom received federal help.
So, the absurd GOP House Energy & Commerce Committee Report which claimed that only 67% of exchange QHP enrollees are paid up has been thoroughly demolished by not just myself, but pretty much every other legitimate news media outlet there is (which leaves out FOX News, I'm afraid). In addition to only running through 4/15 (when 38% of the total QHP payments weren't even due yet), it only counted 160 of the 300+ insurance providers on the ACA exchanges, among many other ludicrous methodological flaws.
However, something did just occur to me. Take another look at their state-by-state breakout (which, again, only includes states on the Federal exchange...and even then, leaves out Idaho and New Mexico for reasons unknown), and there's several states which I find rather interesting:
Avera reported about 8,950 South Dakotans had both enrolled in its plans and paid their first premiums since the enrollment period began in October. Sanford reported 1,443 and DakotaCare 59. The total is 10,450, but the government relaxed the March 31 deadline and some enrollments are still coming in. The insurers also have some applicants who enrolled but didn't complete the purchase by paying their first premiums.
Avera, in earlier phone surveys, found that 54 percent of enrollments effective in January and February were people without coverage. Avera is studying the issue further and is working with Augustana College to explore what consumers care about most in a decision to buy.
Read that carefully--54% of the January and February-start policies were previously uninsured. That means people who enrolled between 10/1/13 - 1/15/14. All indications (and logic) are that those who enrolled later than mid-January are more likely to be newly-insured than the earlier enrollees.
Nice find out of South Dakota from contributor Maurice H.; SD was at 6,765 on 3/01. This represents only an 8% increase over February's rate in March so far, although I'm not sure how much "just over 8K" is or what date that number runs through (I'm assuming 3/20).
Just over 8,000 people have signed up for health care coverage in South Dakota. Those signing up in the last week will also need to pay their first month's premium to get coverage. But those premiums may be lower than people expect.
"In the state of South Dakota about 90 percent of the people purchasing insurance are getting subsidies from the federal government," Krystolpolski said.
UPDATE: On the down side, I was off by 4% this time around.
On the up side, I UNDERESTIMATED:
Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.
Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:
As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
If you want to get REALLY specific, call it 902,800 and 4,202,292.
I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!
A 42% increase from South Dakota since 12/23 is pretty good by itself. However, this number only covers 2 of the 3 insurance companies participating in the exchange. I have no idea what sort of market share the 3rd company has in SD, so I can't speculate as to how many more enrollments they have to add to the total.
I've also subtracted a the corresponding 1,000 difference from the "unspecified" Federal pool at the bottom of the spreadsheet to compensate.
As of Jan. 1, about 3,550 people in South Dakota had signed up through the federal marketplace website from Avera and Sanford, with about 2,700 from Avera and about 850 from Sanford. DakotaCare figures weren’t available.