The start of the New Year means the start of a 2020 legislative session. I am back in Pierre as your state representative. I am looking forward to it. Over the past couple of months, I have been meeting and listening with people in Yankton to learn what issues are important to you. I even put a survey online, which you can still take at this website: http://www.surveymonkey.com/r/cwachconstituentsurvey.

Like you, I am concerned about the cost of our health care system. The United States has a truly tremendous health care system with excellent medical personnel and state-of-the-art equipment, but the cost of health care can make access to necessary care difficult for many and impossible for some. And the costs continue to rise. This is especially true for small businesses and individuals that have to access healthcare insurance on the marketplace. But it’s not true everywhere.

Health care premiums fell 34.7% in Alaska in 2017 and have stayed down! In North Dakota, health care premiums fell 19.8% in 2019. Montana healthcare premiums dropped 8%. Over the past several years, 12 states have seen their collective healthcare premiums drop 16.9%. These states have also seen more competition on the marketplace.

What’s their secret?

These states have been able to reduce health care premium because they have adopted a medical reinsurance program. How these programs work and lower rates is complicated, but in brief, it’s insurance for insurance companies. When an insurance company has a catastrophic claim, the insurance company can access this secondary market to cover the costs instead of asking other insurance members to cover the cost. With the risk of the largest claims spread out, insurance companies are able to lower rates.

Medical reinsurance programs also save the federal government money, and under the Affordable Care Act, the feds pass the savings to the states to run this program. Alaska received $58.5 million in federal money after it adopted a medical reinsurance program. North Dakota received $26.1 million. Each state has had to contribute money to the program as well. Alaska only had to contribute $1.5 million while North Dakota has to contribute $21.2 million. Some larger states have had to contribute significantly more.

And in South Dakota, initial estimates for a medical reinsurance program conclude that we could reduce health care premiums by 20%, saving each family on average $1,600 per year, with the state government only having to contribute $7.8 million into a reinsurance program. That’s $7.8 million to save South Dakota families on the marketplace a total of $54.9 million — that’s a lot of money to put towards mortgages, retirement, or into wages.

Democrats in New Jersey and Colorado and Republicans in Montana and Alaska have all adopted medical reinsurance programs for their states. A health care plan that brings Democrats and Republicans together? That’s how I know it’s a good idea that should come to South Dakota.

So, after months of quiet research at home, my main piece of legislation will be for the creation of a medical reinsurance program.

I am also going to bring legislation to create a prepaid college program and to create a study to find better ways to fund our long term care system. Young people should not have to go into significant debt to get an education and our older generations should not have to go broke to go to the nursing home.

Of course, there will be 104 other elected officials with their favored legislation. Gov. Noem will have her priorities, as well. I’ll continue to work with Republicans and Democrats on ways to improve our quality of life in South Dakota, and I think that starts with a budget that prioritizes our state employees, disaster recovery and education.

Politics can be frustrating, but with your continued support and advocacy, I am confident that we can work through that frustration together. At times, I will certainly need it! Politics is about the art of the possible. When we work together with the common interest in mind, our opportunities and possibilities grow. I am committed to turning frustration into opportunities. Please keep in contact with me at Ryan.cwach@sdlegislature.gov, so we can continue this work together.

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