DakotaCare to leave federal exchange

Just two companies in South Dakota will offer individual health care policies on the federal exchange in 2016.

DakotaCare offered about 7,000 individual health care policies this year on the federal health care exchange set up by the Affordable Care Act, but it won't offer the policies next year because the company can't afford them, DakotaCare CEO Kirk Zimmer said.

"It's not sustainable to a point that we wouldn't want to endanger other policies," Zimmer said.

The company's roughly 7,500 individual customers who bought policies directly will not be affected, nor will the policy holders who receive health care through their employer.

The thousands whose policies will be discontinued next year were notified in a letter that they'll have to move to Avera Health Plans or Sanford Health Plan for next year, Zimmer said.

"No one should be left out without coverage," Zimmer said.

Jeff Sandene, interim president at Sanford Health Plan, said the company would be prepared to take on the additional members.

“Sanford Health Plan has the infrastructure in place to handle any additional enrollments that may result from DakotaCare leaving the exchange for 2016," Sandene said.

In South Dakota, 21,393 consumers selected or were automatically re-enrolled in in health insurance coverage through the exchange as of February 22, according to the U.S. Department of Health and Human Services.

DakotaCare and Wellmark Blue Cross Blue Shield will be the state's other two options for plans off the exchange.

Open enrollment for federal exchange health care plans opens November 1 and closes December 15 for coverage beginning January 1, 2016.

Zimmer said DakotaCare's decision to remove its individual policies from the exchange might not stick.

"That's the group's decision for 2016 — it might not be permanent," Zimmer said. "We're going to take it one year at a time."

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