PIERRE, S.D. (AP) — South Dakotans who need health insurance can start enrolling Oct. 1 through a new online marketplace, but most haven't heard much yet about the insurance exchange required as part of the national health overhaul law.
That's partly because state government, which has chosen to let the federal government set up and run South Dakota's exchange, will not play a role in promoting the exchange or helping people sign up for insurance.
However, a number of health care organizations and other groups are gearing up to help people comply with the requirement that those who can afford it must get insured or face a tax penalty. People of modest means will get government help in paying for insurance.
Officials don't know how many people will seek to buy insurance through the exchange. About 105,000 South Dakotans, or 13 percent of the state's population, are uninsured, according to recent surveys.
The federal government recently awarded nearly $578,000 to six health centers that will help people enroll in health insurance policies offered through the exchange. Another $600,000 in grants will be awarded later.
John Mengenhausen, CEO of Horizon Health Care Inc., based in Howard, said the organization will use its $111,000 grant to hire three or four people who will be trained to help people research the marketplace and get the best insurance they can afford. Horizon Health provides primary care and routine exams in 13 medical clinics and four dental clinics in small towns, and it charges patients on a sliding scale based on their income.
Horizon also will hold public meetings and run ads in local newspapers and radio stations to let people know the help is available. It likely will work with churches and other organizations that plan to use volunteers to explain the insurance program, Mengenhausen said.
Mengenhausen hopes the state will eventually join in promoting the exchange.
Eric Matt, an aide to Gov. Dennis Daugaard, said the state decided not to take part in any marketing effort or consumer assistance for the health exchange. The governor decided to let the federal government set up the exchange in South Dakota, but state government will regulate insurance companies that offer policies through the exchange.
Avera Health Plans, Sanford Health Plans and DAKOTACARE have submitted plans to offer policies for individuals and small businesses through the exchange.
The state also has delayed a decision on whether to expand the Medicaid program to cover people considered too poor to get the subsidized private insurance offered through the exchanges. South Dakota's Medicaid program now covers about 116,000 children, adults and disabled people. The expanded eligibility would add an estimated 48,000 people, mostly adults without children.
Dave Hewett, president of the South Dakota Association of Health Care Organizations, said the association is working with national groups and South Dakota hospitals to continue helping patients find coverage through Medicaid or the new health insurance exchange. A plan to reach those people is still being worked out, he said.
Hospitals want more people covered by insurance so they no longer wait until they are severely ill and go to an emergency room, Hewett said. People with insurance get treated early and avoid more costly problems, he said.