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Daugaard Medicaid Expansion Returns Federal Share of Budget to Rounds-Era Average

It bothers me that some people who can work will become more dependent on government…. I hate that. I hate dependency. 

—Governor Dennis Daugaard, FY2017 budget address, quoted in Jonathan Ellis, “Medicaid Expansion and Obamacare,” that Sioux Falls paper, 2015.12.08

Ken Santema’s complaint about Governor Dennis Daugaard’s willingness to expand Medicaid entirely on the federal dime gets me thinking about South Dakota’s historic reliance on federal funds.

Santema notes that Governor Daugaard appears to have abandoned his “doubts about the federal government’s ability to deliver on their promises”:

For the last few years Daugaard has been saying at least one of the reasons he does not want to expand Medicaid is because of the switcheroo the Federal Government often does when offering money to states. I agree with what he says. Yet when I look on paper I can’t help but get nervous about how much money the state of SD is going to rely upon the federal government for. This is especially true for Medicaid expansion federal dollars (which is included in that increase). Taking more federal dollars is NOT free money. Rather, every federal dollar taken by the State of SD increases the federal deficit; which in turn further taxes the people of the United States by eroding purchasing power [Ken Santema, “A Brief Look at the Governor’s Proposed FY17 Budget,” SoDakLiberty, 2015.12.09].

Governor Daugaard is asking the Legislature to approve $373,644,565 in additional spending authority for the federal funds that would accompany Medicaid expansion, if the feds approve the Governor’s Medicaid-IHS swap. Without that budget item, the federal funding in the Governor’s FY2017 proposal would actually decrease by $8.85 million from FY2016.

As it stands, Governor Daugaard relies on federal funding for 42.09% of his FY2017 budget. He had been showing some hint of weaning South Dakota back to self-reliance: after the Rounds-era stimulus peak of $1.723 billion in FY2010, federal funds had dropped to $1.348 billion in FY2015. That’s a decline from 46.52% of the budget to 34.99%. But Daugaard put 23.68% more federal dollars in the current budget and 21.88% more federal funds in the proposal for next year’s budget.

As more than three quarters of the total FY2017 budget increase, $373 million to expand Medicaid looks like an enormous increase in South Dakota’s reliance on Uncle Sam. But that 42.08% federal share of the FY2017 budget is just a touch higher than the 41.72% average federal share of the eight budgets of his predecessor, Governor Mike Rounds.

Santema may be nervous about how much money the state is relying on Uncle Sam for. Counting on the federal government for a quarter, a dime, a nickel, and a couple pennies out of every dollar in the state budget isn’t terribly self-reliant or Republican… but it’s pretty normal—and dare I say vital?—for South Dakota.

12 Comments

  1. jerry 2015-12-10 10:11

    Who is the governor speaking of? How many people do any of us know that refuse to work so they can live off the government? How do they do that? Is he speaking of women with children? Does anyone know, including Daugaard who the hell he speaks of?

    “It bothers me that some people who can work will become more dependent on government…. I hate that. I hate dependency.”

  2. WayneF 2015-12-10 11:39

    Very good question Jerry. Whom the heck is Daugaard referring to?

  3. Porter Lansing 2015-12-10 11:58

    MARCO RUBIO IS RESPONSIBLE FOR YOUR HEALTHCARE PREMIUM INCREASES
    If I May … I have a strong background in healthcare insurance, having been involved in procurement for our members as an elected Teamster official. I was blindsided this year when several insurance companies were losing money over Obamacare policies they’d sold. When we wrote the ACA, this scenario was discussed and provisions were made for this possible direction. “RISK CORRIDORS” were included in the first three years of implementation. Now the truth is coming to light!!! ~ A little-noticed provision that Senator Marco Rubio slipped into a giant spending law last year is quietly undermining the health care law and is responsible for your premium increases this year.
    NYTimes – Risk corridors were intended to help some insurance companies if they ended up with too many new sick people on their rolls and too little cash from premiums to cover their medical bills in the first three years under the health law. The payments were supposed to help insurers cope with the risks they assumed when they decided to participate in the law’s new insurance marketplaces. But because of Mr. Rubio’s efforts, the administration says it will pay only 13 percent of what insurance companies were expecting to receive this year. Without them, insurers say, many consumers will face higher premiums and may have to scramble for other coverage. Already, some insurers have shut down over the unexpected shortfall.

  4. jake 2015-12-10 15:16

    Porter, this sounds very truthful indeed. Those opposed all these years to the ACA would definitely sabotage it in such manner. Rubio and his counterparts would rather see the billions going into the defense industries than into providing healthcare assistance to the nation

  5. jake 2015-12-10 15:31

    Makes one wonder how he feels about the dependency of those suckling all the program dollars for their own use: EB5, GEAR-UP, etc etc. Included could be those in the ag sector that ‘rape’ the Farm Bill as some used to rape the land.

  6. Porter Lansing 2015-12-10 15:33

    @Jake Yes, sir. It’s the New York Times. That’s as truthful as you can get. One political party is happy to sacrifice your monthly insurance cost just to make our President less successful. Despicable behavior. Even the sturdiest ship will go down when a rat eats through the hull.

  7. jerry 2015-12-10 15:45

    @Porter Lansing, the first to call this out was Timothy Carney at the Washington Examiner one year ago today on 12/10/2014. Why the insurance companies have not been honest about this when they sent out the 50 and 60 percent increases is clear, they do not want to rock the republican positions. Did you ever wonder why when Blue Cross and Dakotacare went to the state for approval of their increases, there was not a whimper and they approved it without debate.

  8. Porter Lansing 2015-12-10 16:27

    If health insurance carriers aren’t actively diversifying their assets immediately, the millions they’re paying their CEO’s is truly a waste. Health insurance is soon to be a historical reference. Single payer eliminates 20% of overhead costs and can easily meld to the Medicare paradigm with little friction. Medicare equals low administrative cost and very high approval.

  9. leslie 2015-12-10 20:48

    just an opinion, but no way is daugaard going to leverage the feds into changing IHS ect. unless it is a brilliant, new idea, and daugaard ain’t a savant. and increasing taxes to pay for eventual single payer medical care for all, seems obvious as does increasing taxes to pay teachers.

    daugaard is just going to keep killing south dakotans that don’t have his kind of state purchased health care at 30-90 per year average (which has turned out to be more like 100 per year).

    only from republicans–bought and paid for.

    :) imo

  10. Donald Pay 2015-12-10 20:50

    Here’s something from out in Idaho that caught my eye, and has some budget implications for higher education and radioactive waste disposal.

    http://magicvalley.com/news/local/idaho-south-dakota-universities-to-expedite-nuclear-engineering-degrees/article_f5dcb9d8-d5d8-5f2e-9b96-b72a900b2712.html

    South Dakota State University is partnering with Idaho higher education to have a nuclear engineering master’s program. Idaho does not have a nuclear power plant, but they do have a lot of defense radioactive waste that they have been trying for decades to get rid of. South Dakota entities are looking at hosting a deep borehole disposal site in crystalline rock in eastern South Dakota or, perhaps, in shale in western South Dakota.

    A number of academic scientists and university heads from both Idaho and New Mexico, another state with a lot of defense nuclear wastes, have, over the past several years, developed a beachhead in South Dakota. This follows a pattern that the Obama administration’s Department of Energy has plotted with their “consent-based” approach to siting high-level radioactive wastes.

    This latest effort regarding a nuclear engineering degree seems rather innocuous. However, developing an in-state lobbying infrastructure for selling out the state to the federal Department of Energy is one of the clear prerequisites of the DOE’s approach.

    Idaho has had an even worse experience with nuclear power than South Dakota. The Pathfinder Plant near Brandon, SD, shook uncontrollably in it’s first full-power test in 1967, and was immediately shut down and abandoned. No known deaths occurred immediately, though many of the workers who went in to partially decommission the plant soon thereafter suffered various cancers a decade later, probably from the effects of radiation and/or asbestos. However, one of Idaho’s two experimental nuclear power stations did kill a number of people during an accident. The other plant also had significant problems and was shut down.

    With a record like this every proposal in Idaho to build another nuclear power station has faced stiff opposition. There have been two attempts to site a nuclear power station in recent years, but both seem to have been scams. One group faced criminal investigation.

    Idaho Governors, both Republican and Democrat, have resisted federal efforts to site a permanent radioactive waste facility in that state, even though it might make some sense to bury the stuff right where it is. They all have seen how the Department of Energy lies, obfuscates and weasels out of agreements. Though they would like to see South Dakota take that waste out of Idaho, all past evidence from Idaho suggests that a South Dakota governor who agrees to take the defense wastes stored in Idaho would be a fool to do so.

  11. jerry 2015-12-10 21:12

    Good find Mr. Pay. By having the states and the world ship all their radioactive sludge here, we will not have to use our own electricity at night. Nothing says rush to the Rushmore state like the warm iridescent glow of nuclear decomposition. If we play our cards right, these states may even put a fence around us so we can keep this stuff to ourselves. Republican leadership, leadership that glows.

  12. leslie 2015-12-10 22:24

    ditto, don.

    thx for the heads up porter to this deeply important turn of events, worrying about rising premiums and deductibles.

    http://www.diversityinc.com/news/marco-rubios-quest-to-kill-obamacare-to-affect-latinos-blacks/\

    Rubio argued the [risk corrodor part of the ACA]program would lead to taxpayer bailouts of insurers. He boasted his hidden provision saved taxpayers $2.5 billion in bailout money. Fact-checking site PolitiFact rated his assertion “mostly false.”

    His sabotage will result in the federal government paying only 13 percent of the amount expected by insurance companies this year, which is much less than the $2.9 billion requested by insurers that saw losses on the exchanges.

    In the wake of the unexpected payment reduction, some insurers have already shut down.

    Dawn Bonder, president of Health Republic of Oregon, said her insurance co-op will be forced to close its doors after receiving only $995,000 of the $7.9 million expected from the federal government.

    “Risk corridors have become a political football,” Bonder told the New York Times. “We were stable, had a growing membership and could have been successful if we had received those payments.”

    On Nov. 24 Rubio’s presidential campaign sent out the following tweet on Twitter:

    Rubio did not kill the ACA, but according to an expert on the act, he fulfilled much of what the Republicans desire to do, which is at the expense of Americans seeking health care.

    “It did draw some blood,” Tim Jost, health law professor at Washington and Lee University School of Law, said in November.

    ***
    “The restriction on funding is probably the most effective thing Republicans have done so far to limit the Affordable Care Act, other than the Supreme Court decision [in 2012] and subsequent decisions by Republican states not to expand Medicaid.”
    ***

    [gulp! these good ol’e boys play hard ball. these guys are disgusting, illustrated below, just like Romney-care].

    Republican leaders are against risk corridors, but it was something the party created to “smooth out” rate increases in prescription drug coverage under Medicare. Both Senate Minority Leader Mitch McConnell and Former House Republican Leader John Boehner voted in 2003 to create Medicare Part D.

    Politico Magazine reports: “An innovative part of the law McConnell and Boehner voted for was its ‘risk corridors’ program, a new idea back in 2003 … At the time, Sen. Chuck Grassley (R-Iowa) described the Part D risk corridors as one of the ‘incentives that the secretary can use’ to get the new plans started ‘in a strong way’ …”

    did Rubio sign the l to iran too?

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