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State, navigators prep for health exchange launch

Americans will be eligible to apply for health insurance under the healthcare reform law known as Obama care beginning Tuesday. Shown here is the short form for the new federal Affordable Care Act application. (AP Photo/J. David Ake)

By Dirk Lammers

SIOUX FALLS (AP) — South Dakota is letting the federal government set up its insurance marketplace under President Barack Obama's health insurance overhaul, but state officials and organizations charged with getting the word out have been busy preparing for Tuesday's start of open enrollment.

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South Dakota is one of 36 states letting the feds run the health exchanges, and technical staff has been spending a lot of time trying to get state and federal computers talking to each other, said Eric Matt, a policy adviser to Gov. Dennis Daugaard.

Matt said unclear federal regulations, numerous last-minute changes, inadequate testing on the federal side and postponed deadlines have made that a challenge.

"We'll see how it works," he said. "I'd be shocked if it was glitch-free."

The online marketplaces will be a place where people can buy health insurance as part of the effort to reduce the number of uninsured people.

Officials don't know how many people will visit the site Tuesday, when people can begin signing up for coverage that would start Jan. 1. About 105,000 South Dakotans, or 13 percent of the state's population, are uninsured, according to recent surveys.

In South Dakota, the state Division of Insurance has certified Avera Health Plans, Sanford Health Plan and Dakotacare to offer plans, said Melissa Klemann, the division's assistant director of life and health insurance.

Klemann said the state is not putting any resources into marketing the health exchange, leaving that to private and non-profit health organizations. She said she's not sure whether residents will flock to the site Tuesday or whether traffic will build over time.

"I think we're all anxious to see what that Oct. 1 date will do," Klemann said.

The Great Plains Tribal Chairmen's Health Board last month received a $264,000 grant to help spread the word to Native American residents of the Dakotas.

Native Americans are exempt from the Affordable Care Act's requirement that people carry health insurance or pay a fine because they get free health care through the Indian Health Service, a branch of the Department of Health and Human Services.

But "navigators," whose job is to help residents choose coverage, will be encouraging tribes and tribal members to enroll because the resources available through IHS are so limited, said Jerilyn Church, the Great Plains Tribal Chairmen's Health Board's executive director.

Church said the board is first training navigators in IHS clinics and facilities. It will then reach out to tribal health clinics that run their own IHS programs and urban Indian health programs in Sioux Falls, Rapid City and Pierre.

Navigators will have to go through 20 hours of online training offered by the Centers for Medicare and Medicaid Services.

"Anyone who takes training will be in a position to help guide families on what might be the best option for them based on income, size of family," Church said. "It's going to be I think a very busy year just ensuring people get the right information and can make the right choices for themselves, and make sure that everybody has coverage in some way, shape or form."

A U.S. Department of Health and Human Services report released last week found that South Dakota residents will pay more for health insurance than people in surrounding states under the federal exchange.

Average premiums for the lowest-level plan for a South Dakota family of four with an income of $50,000 will be $141 a month after tax credits. To the north, North Dakota residents would pay $111 for the same coverage, while Nebraska residents will pay $113 and Wyoming residents will pay $81. Klemann said officials were still analyzing the report, but she's surprised it's showing higher costs in the state.

Church said she's expecting a busy year of ensuring that people get the right information and can make the right choices. She's said it will take a while to spread such a complex message.

"Health reform is so new, and it's obviously going to change the landscape how health care is delivered in this country, as well as in Indian Country," Church said. "Many people who are involved in the health care industry, we're all in a learning curve together, but it's important to stay apprised and abreast of the changes and opportunities."