Federal & State Regulations | State insurance exchanges - South Dakota

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Summary of differences between federal and state regulations

The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that states may submit both a letter of intent and an application to operate its own exchange by December 14. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.

In May 2012, Governor Daugaard’s office announced that South Dakota had not decided whether to pursue a state-based health insurance exchange and would wait until after the Supreme Court decision on the Affordable Care Act. The South Dakota legislature did not introduce any exchange-related bills in 2011 or 2012; however, in March 2012 the state enacted a law (HB 1185) prohibiting plans in a state exchange from providing abortion coverage except when necessary to preserve the life or health of the pregnant woman.

South Dakota received a $1 million Exchange Planning grant and its Division of Insurance was awarded a Level One Establishment grant of $5.9 million.

December 14, 2012, is the deadline for South Dakota to submit an exchange blueprint consisting of a declaration letter signed by Governor Daugaard and an application to the U.S. Department of Health and Human Services, if it intends to operate a state-based exchange or a state-federal partnership exchange. However, without legislation in place, it is unlikely the state will meet the federal timetable for implementation.