Health insurance in Minnehaha County, South Dakota
2 insurers sell 41 marketplace plans here, and 9.4% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Two insurers, and what that means
Two insurers sell here, offering 41 plans between them. If either leaves, Minnehaha County becomes a single-insurer county. Each insurer averages about 20 plans, so most of the choice here is between products from the same company rather than between companies. The number has not changed since the previous plan year.
How many people here have no coverage
9.4% of Minnehaha County's 175,330 under-65 residents have no health coverage — 16,422 people. That is close to the South Dakota rate of 9.9%, and puts Minnehaha County in the middle half of the 1,817 counties on this site (1178th).
How much the marketplace is used
8,638 Minnehaha County residents selected a marketplace plan for 2026: 49 per thousand under-65 residents, 1601st of 1,817. That is under the 78 per thousand typical of published counties. 1,385 of them — 16% — were new rather than renewing.
Minnehaha County against South Dakota
Minnehaha County is the largest of the 3 South Dakota counties we publish, by under-65 population. Its uninsured rate tracks the state almost exactly and with 2 it has the fewest insurers of any South Dakota county. Marketplace use is well under the South Dakota rate.
| Minnehaha County | South Dakota | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 9.4% | 9.9% | 9.9% |
| Insurers selling | 2 | 2–3 | 4 |
| Plans offered | 41 | — | 57 |
| Selections per 1,000 | 49 | 70 | 78 |
| New rather than renewing | 16% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Kaufman County (Texas) | 174,481 | 18.7% | 3 | 48 |
| Elkhart County (Indiana) | 173,285 | 13.4% | 3 | 47 |
| Caddo Parish (Louisiana) | 173,151 | 8.8% | 5 | 63 |
| Sarpy County (Nebraska) | 177,825 | 5.4% | 5 | 81 |
Caddo Parish has 5 insurers against this county's 2 — a reminder that the county line, not the state line, is what decides your options.
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