Providing the home-based and community-based care that the Department of Justice says we must to comply with the ADA could save us half the money we need to foot the state’s small share of Medicaid expansion. A new analysis shows we can easily get the rest—and more than we thought!—to cover Medicaid expansion by transferring American Indian Medicaid recipients to Indian Health Service funding:
In South Dakota’s 2015 budget year, the state identified a total of $67 million in state Medicaid spending that could be reduced by the federal changes and redirected to covering the cost of expansion. With the new analysis, the total amount of Medicaid spending identified as available to turn into savings jumped to about $85 million.
“This news is very exciting because the governor has said all along that he does not want to support this unless it is budget-neutral,” said Tim Ridgway, president of the South Dakota State Medical Association. “We think it is just a tremendous opportunity for those patients” [James Nord, “Funding Could Make South Dakota Medicaid Expansion Easier,” AP via Rapid City Journal, 2016.05.04].
I’d ask what we’re waiting for on that special session to expand Medicaid, but it seems logical that Governor Dennis Daugaard won’t make that call until after the Legislative primaries, when his favored Republicans have beat out the lingering Tea Party nutbars who would not brook such liberal madness as providing affordable health coverage to 50,000 more South Dakotans. After all, the Koch brothers’ front group Americans for Prosperity and certain anti-government hangers-on are still gasping against ObamaCare:
“Whatever savings they think they might have found, I don’t think it will bear out in South Dakota,” Ben Lee, state director of the conservative political advocacy group Americans for Prosperity, said. “And the consequences of that are pretty substantial.”
And Rep. Don Haggar, R-Sioux Falls, said the state shouldn’t trust the federal government to provide health care insurance for an estimated 50,000 additional South Dakotans, as IHS has repeatedly shown that it can’t effectively provide safe health care for the state’s American Indian population.
“The situation we’re seeing with IHS is an unmitigated disaster,” Haggar said. “It’s a complete travesty and that’s just what happens when you let the federal government handle health care” [Dana Ferguson, “Special Session for Medicaid Expansion Still on the Table, Top Health Secretary Says,” that Sioux Falls paper, 2016.05.03].
Just get us past the primary, and then Governor Daugaard will be free to call that Session. With Donald Trump at the ticket, all is lost for Republicans in November, so the Governor may as well go ahead and do the right thing with Medicaid expansion.