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South Dakotans having less trouble in Affordable Care Act's second round

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PIERRE, South Dakota — Buying coverage during the Affordable Care Act's second open enrollment period hasn't been as difficult for South Dakotans as it was during the program's inaugural window.

Monday is the final day for South Dakotans to enroll in health coverage for Jan. 1 through the federal health insurance exchange, but the enrollment period doesn't fully wind down until February. Avera Health Plans Chief Administrative Officer Deb Muller said Friday the process so far for consumers has been "a little disjointed this year, but nothing like it was last year."

Avera, Sanford Health Plan and DakotaCare offer coverage to South Dakotans on the exchange. People who were previously turned away from insurance plans because of pre-existing conditions don't have to worry about being barred from insurance under the Affordable Care Act. Consumers are only eligible for federal subsidies if they shop through the exchange, though coverage is available outside the marketplace.

Avera is seeing three categories of customer this year, Muller said, including: people who are actively re-enrolling in coverage and shopping around, people who are simply staying with their existing plans and consumers who "sat on the sidelines" last year and who are checking out the marketplace for the first time.

More than 13,000 South Dakotans signed up for individual private insurance through the federal exchange in last year's open enrollment period, according to official data released in April. Muller said it's unclear how many South Dakotans have enrolled this year because the company isn't getting clear information.

"We're just as curious as everybody else is right now, honestly," she said.

Though the exchange's technical functionality has improved significantly since last year, Muller said it appears some South Dakotans using a tool on Healthcare.gov to get a preliminary cost estimate of coverage may not be receiving accurate information. She said the company is working with the feds to understand the problem.

Muller also said as the holidays approach, consumers should remember that the open enrollment period doesn't end until Feb. 15 — the deadline to avoid a federal penalty.

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