According to data[i] released today by the US Census, 17% of all non-elderly South Dakota adults (age 18-64) were uninsured in 2013
WHAT ARE THEIR OPTIONS?
Beginning in 2014, some of these 80,881 uninsured South Dakotans had a new option through the federal healthcare exchange to access subsidized coverage – some did not.
Eligible for Subsidies on the exchange: About 50,000 (61% of the uninsured) would likely have been eligible for a premium subsidy on the federal exchange because their household income fell between 100% and 400% of the federal poverty level. Subsidies for these individuals would cap their insurance premiums at between 2% and 9.5% of household income (see Graph 1). Approximately 13,000 South Dakotans have purchased health insurance on the exchange in 2014. The 2015 open enrollment period for federal exchange begins November 15, 2014.
Income too high for subsidies: About 8,000 (10% of the uninsured) are ineligible for subsidies because their household income is TOO HIGH—over 400% of the federal poverty level. These individuals could still buy insurance on the exchange where they are guaranteed coverage at standardized rates regardless of their health condition, but they would have to pay the full premium.
Income too low for subsidies: About 24,000 (29% of the uninsured) are ineligible for subsidies because their household income is TOO LOW—less than 100% of the federal poverty level.
Ironically, the Affordable Care Act excludes the poorest of the uninsured from access to the subsidies that are available to their higher-income neighbors in households with incomes between 100-400% of the poverty threshold.
Why is this the case? The original Affordable Care Act legislation required all states to expand Medicaid to cover this population. The Supreme Court overturned this requirement allowing states like South Dakota, to choose NOT to expand Medicaid. Twenty-one states are currently not moving forward with Medicaid Expansion, twenty- seven and the Districts of Columbia have expanded Medicaid and the issue is in open debate in two states.
[i] 2011 – 2013 American Community Survey Statistics Annual Demographic, Socio-Economic and Housing Characteristics for Smaller Areas ,http://census.gov/newsroom/press-releases/2014/cb14-tps80.html