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).
South Dakota's 2021 individual & small group market rate filings are up, and there's not much to say about any of them: Individual premiums are going up around 2.6%, small group market policies around 2.8% overall statewide.
I'm not sure how this happened, but it looks like I missed posting about South Dakota's requested 2020 premium rate filings. No matter, though, because the approved avg. rate increases (for unsubsidized enrollees) are exactly the same as what Avera Health Plan and Sanford Health Plan asked for anyway.
Statewide, South Dakota is looking at 6.5% average hikes for 2020.
But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:
This is a pretty minor update, but I'm trying to lock in all of the approved 2019 rate changes as they come in. Last month, South Dakota's two carriers, Avera and Sanford, posted requested rate increases which I thought were 2.6% and 10.0% at the time. I also estimated their relative enrollment at around 27,000 and 4,000 enrollees apiece for market share calculations, which gave a statewide average increase of around 3.5%.
I checked the South Dakota Insurance Division website again today, and it certainly looks like the filings have been approved by the state insurance regulators...however, when I double-checked the filings themselves, it looks like they were actually slightly lower than I thought: 2.5% and 9.7% respectively.
In addition, I was able to find the hard enrollment numbers for each...the total is pretty close to what I had it at (29,180 vs. 31,000), but the splut is quite different. Insetad of Avera still having an 87% market share, it looks ike the split is more like 63/37 this year. Since Sanford is requesting a significantly higher increase than Avera, that means the weighted statewide average is higher as well...around 5.2% instead of 3.5%.
South Dakota has two ACA indy market carriers, Avera and Sanford. The relative enrollment market shares are based on last year's numbers. The 14.4% #ACASabotage impact assumes 2/3 of the Urban Institute's projections to err on the side of caution.
THe average unsubsidized SD indy market enrollee pays $624/month this year; instead of that dropping by around $68/month, it's expected to increase by $22...for a total monthly difference of $90.
Assuming that's accurate, this means unsubsidized SD residents will be paying over $1,000 more apiece next year than they'd otherwise have to.
Protect Our Care is a healthcare advocacy coalition created last December to help fight back against the GOP's attempts to repeal, sabotage and otherwise undermine the Affordable Care Act. This morning they released a report which compiled the approved 2018 individual market rate increases across over two dozen states.
Needless to say, they found that the vast majority of the state insurance regulators and/or carriers themselves are pinning a large chunk (and in some cases, nearly all) of the rate hikes for next year specifically on Trump administration sabotage efforts...primarily uncertainty over CSR payment reimbursements and, to a lesser extent, uncertainty over enforcement of the individual mandate penalty.
South Dakota is another fairly straightforward state: Two carriers, around 31,000 total ACA-compliant enrollees on & off exchange. Neither filing indicates whether they're assuming CSR payments will be made or not, so I'm assuming they're based on them being paid.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
A proposal to expand a federal health insurance program for needy people could be off the table following the results of Tuesday's election.
The victory of Republican Donald Trump, who has called for a repeal of Obamacare, along with the increasingly conservative Republican make-up of the South Dakota state Legislature could thwart Gov. Dennis Daugaard's efforts to expand Medicaid in the state.
Daugaard for more than a year has worked with the Obama administration and the Indian Health Service to strike a deal, which stemmed the approval of a federal policy that allows the state to spend less on Medicaid-eligible Native Americans. And part of that bargain has been staked on South Dakota using the savings to cover an additional 50,000 South Dakotans under Medicaid.
Trump hasn't set a clear policy position on Medicaid expansion but has said he'd repeal the Affordable Care Act, though two of his closest allies, New Jersey Gov. Chris Christie and Indiana Gov. Mike Pence, have accepted Medicaid expansion.
