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South Dakota

Affordable Care Act overview

The Affordable Care Act is the nation’s health reform law enacted in March 2010. It contains numerous provisions designed to expand health coverage to 30 million Americans; increase benefits and lower costs for consumers; provide new funding for public health and prevention; bolster our health care and public health workforce and infrastructure; foster innovation and quality in our system, and more.

Many Americans have misgivings about the Affordable Care Act. A CNN/ORC poll conducted in September 2013 showed support for the law at 39 percent, down from 51 percent in January 2013. Opponents say the country can’t afford the ACA. They say it won’t cut the cost of health care, but will expand the deficit, weaken the economy and cause employers to cut jobs. The Republican-led House of Representatives has voted dozens of times to repeal all or part of the law, but those efforts have gone nowhere in the Senate, where Democrats have the majority. President Barack Obama has postponed implementation of the so-called employer mandate until 2015, but shows no indication he will back down on what many consider to be the signature accomplishment of his first term.

The law consists of two pieces of legislation: the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA). Jointly they are referred to as the Affordable Care Act or ACA. The information below comes from the U.S. Department of Health & Human Services.

How the ACA may affect South Dakota

Because of the Affordable Care Act, the 87 percent of South Dakotans who have insurance will have more coverage choices than before. And for the 13 percent of South Dakotans who don’t have insurance, or South Dakota families and small businesses who buy their coverage but aren’t happy with it, change is coming.

Soon, the new online Health Insurance Marketplace will provide families and small businesses that currently don’t have insurance, or are looking for a better deal, a new way to find health coverage that fits their needs and their budgets.

Open enrollment in the Marketplace starts Oct. 1, with coverage starting as soon as Jan. 1, 2014. But South Dakota families and small businesses can visit HealthCare.gov right now to find the information they need to prepare for open enrollment.

The ACA provides South Dakotans:

Cheaper prescription drugs for people with Medicare
$6,732,077 in total savings for 10,923 seniors, averaging $616.32 in savings per person in 2011

Free preventive services
151,000 people and 96,351 seniors with Medicare get preventive services for free

No more lifetime limits on care
295,000 people no longer have a lifetime limit on their care

Health insurance on your parent’s plan
5,088 more young adults under age 26 now have insurance on their parent’s plan

New rules on how insurers spend premiums
252,000 people protected by the 80/20 rule that requires insurers to spend 80 percent of premiums on care and quality

Coverage through a pre-existing condition insurance plan
153 people who were uninsured because of a pre-existing condition now have coverage

Affordable Insurance Exchange
$1,000,000 to help states build new marketplaces where consumers will have the same kinds of choices as members of Congress

Money for public health
$2,000,000 in grants to improve public health

Community health centers
$4,000,000 to support and expand community health centers

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