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Will Thune Support Funding Indian Health Service for Daugaard’s Medicaid Expansion?

Pat Powers rushes to tamp down the Robert Pear’s suggestion of a split between Pat’s sponsors Governor Dennis Daugaard and Senator John Thune on Medicaid expansion and the Affordable Care Act. I’ll actually concede Pat’s point and agree that Governor Daugaard and Senator Thune really aren’t that far apart on this issue. Neither one likes the Affordable Care Act. Neither one wants to see President Obama enjoy a legacy of reforming health care and helping millions of Americans enjoy greater health and financial security. But if they can’t grinch America and beat the ACA in Congress or in court, they at least don’t want to pay for the benefits of the ACA.

Pear’s article misses that latter point of miserly agreement, wherein lies the real gulf between South Dakota’s leading Republicans. Governor Daugaard wants the federal government to pick up South Dakota’s share (our small share, no more than 10% by FY2021) by increasing Indian Health Service spending. Instead of following Alaska’s lead and using the Medicaid expansion itself to provide Indians with more health care access, Governor Daugaard wants Uncle Sam to spend $67 million more a year via IHS on top of the $374 million in new ACA-Medicaid spending to actually reduce the amount that South Dakota spends out of its own pocket on both programs.

But to make that happen, Senator Thune will have to convince his colleagues to add $67 million to the Indian Health Service budget. In voting to repeal the Affordable Care Act (as recently as this month!), Thune and his colleagues have been voting to repeal the intertwined Indian Health Care Improvement Act, which repeal would result in cutting millions of dollars from the Indian Health Service. And the budget just passed (pp. 323–327) allocates $3.566 billion for IHS plus $523 million for IHS facilities for what appears to be a total of $4.089 billion, which is short of the $5.103 billion IHS requested for the services it anticipated providing in FY2016, never mind the additional services Governor Daugaard wants it to provide.

Governo Daugaard has been talking about the IHS-Medicaid trade-off since October. The Consolidated Appropriations Act of 2016 wasn’t nailed down until December 16. If Governor Daugaard really wanted the IHS-Medicaid switch to happen, Senator Thune could have made it happen by slipping $67 million into the budget. Instead, Senator Thune supported a budget that appears to do much less than what IHS asked for.

Senator Thune holds the IHS purse strings for the Medicaid expansion Governor Daugaard wants. Therein lies the real gap that must be bridged… an easy gap, if Daugaard and Thune are serious about providing health care to Indians and all South Dakotans.

p.s.: Rep. Kristi Noem sends strongly worded letters to IHS about the delisting of the Rosebud ER, but she’s not sending IHS any more money yet, either.

6 Comments

  1. mike from iowa 2015-12-29 08:51

    As a general observation,wingnuts are something else. They claim we can’t afford to spend money we don’t have,especially for the truly needy,then they can’t wait to serve up more tax cuts for the people who can afford to pay more in taxes.

    They still can’t see the correlation between cutting taxes and having less resources to pay bills with. Or else they are willfully ignorant.

  2. jerry 2015-12-29 10:19

    Senators like Thune and Rounds should be ashamed of themselves for trying to undo something positive for all Americans, rich and poor alike. By having accessibility to doctors, we would be able to help control outbreaks of diseases that could be pandemic. Yes, those are the ones that are like the 1918 flu epidemic that did not know the difference between rich and poor. For them to play politics with the good of the nation is actually close to treason. In the meantime, does anyone remember the tragedy in Paris? Well here is how the French address issues for the good of all of its citizens regarding healthcare. http://www.politico.eu/article/france-health-law-free-doctor-visits-public-health-bill/

  3. Mose 11 2015-12-29 11:36

    Could, sun tans, photo ops be more important than. Our people.

  4. Roger Cornelius 2015-12-29 18:06

    Grandpa Scrooge needs to keep his greedy little hands out of IHS funding.

    Just how will his plan work for Indians living on the reservations where if services are reduced because of funding there will be no services at all.

    Are there any privately owned clinics or doctors office on any of South Dakota’s reservations? If not, Indians will be screwed more now than they already are.

  5. Leslie 2016-01-03 03:07

    I do not trust dugger at all . This is just another way to say no .

  6. mike from iowa 2016-01-03 07:11

    jerry-wingnuts already can’t control outbreaks of rabid rightwingnuttery called teabaggers. Now there is a malaise that should have been nuked in its infancy.but less infected wingnuts chose to concentrate on Obama’s birth cerificate and they have festering patisan wounds all over to show for it.

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