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February 03, 2011 at 07:00 PM
Q: What challenges do you anticipate your particular state running into with upcoming health care reform provisions?
Merle Scheiber: There are major challenges from a fiscal and resource standpoint. Implementation has been a major drain on staff resources requiring other needed issues and projects to be delayed. By far, the greatest fiscal impact will come from the Medicaid requirements; this will shift more people onto state Medicaid. Because Medicaid pays a lesser amount of billed charges than private carriers do, there will be a significant cost shift by health care providers from this significant increase in the Medicaid population. We believe prices will go up and that costs will increase for private pay insurance.
Q: For producers licensed to sell health insurance in your state, what developments might they look out for?
MS: The aspect of PPACA that has the most potential for affecting insurance producers is the health insurance exchanges. Depending upon how they are structured and what market rules are imposed, it could have a dramatic effect on their business model.
Q: Is your state doing anything differently or preparing in any special way for health care reform?
MS: An implementation team made of key management personnel from all affected agencies was formed shortly after passage of PPACA. The planning for implementation has been a major task for South Dakota state government. In particular, the Division of Insurance has expended considerable resources in not only planning for PPACA both the short term and long term, but also adopting state regulations so as to be able to enforce the Sept. 23, 2010 provisions of PPACA under state law.
Q: What did you get out of President Obama’s recent meeting with several state regulators?
MS: While the meeting was cordial and it was an honor to meet with the president and his staff, there was little to indicate that the amount of flexibility the states need in implementing key reforms will be forthcoming.
Merle D. Scheiber was appointed director of Insurance on Aug. 8, 2005 by Gov. Mike Rounds and Secretary of Revenue and Regulation Gary Viken. He worked in the insurance industry for several companies in South Dakota for 25 years prior to being appointed director.
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