Heinemann Fails Fact-Check on Fiscal Impacts of Medicaid Expansion

Dentist and District 8 Republican Rep. Leslie Heinemann thinks expanding Medicaid is too risky. Dentist Leslie Heinemann has apparently never experienced the risk of living without affordable health insurance, a problem that expanding Medicaid would solve for 50,000 South Dakotans.

Proponents of Medicaid expansion say the federal government will pay for this new program, but can we trust the federal government to follow through? The federal government has broken promises before — Indian Health Services, the Veterans Choice and Accountability Act, and the Lewis and Clark Water Project are just three examples. And those broken promises were backed by treaties and legislation [Rep. Leslie Heinemann, “Medicaid Expansion Too Risky for S.D.,” that Sioux Falls paper, 2016.07.01].

Rep. Heinemann here repeats the lie peddled by the Koch Brothers that we need to reject any program funded by the federal government. I await Rep. Heinemann’s vote to reject federal highway dollars and to dissolve the Ellsworth Development Authority, because the federal government could default on its transportation and military budget at any moment.

Rep. Heinemann tries to be a little more logical by citing examples of Medicaid expansion enrolling more people than expected in other states:

Medicaid expansion is a fiscal disaster waiting to happen that endangers our state’s strong fiscal condition. In other states that have expanded Medicaid, enrollment has surpassed estimates, creating access issues as well as skyrocketing costs. In Washington state enrollment ballooned 104 percent over projections, in Nevada enrollment exceeded projections by 113 percent, and in Montana 20,000 enrollees signed up the first day although only 18,600 were projected to sign up during the first fiscal year. These numbers show that no projection, however well-intentioned or conservative, can accurately predict Obamacare Medicaid expansion enrollment [Heinemann, 2016.07.01].

Rep. Heinemann ignores an eleven-state study reported on Dakota Free Press on June 11 showing that Medicaid expansion is saving states and hospitals money. Even with the higher enrollment Rep. Heinemann cites, Washington state has saved over $100 million. As for Nevada, let’s look at the bigger fiscal picture:

The state paid about $522 million in general funds for newly enrolled and existing Medicaid recipients in fiscal year 2014, while it received a match of about $1.4 billion in federal funds that year. With more than 180,000 newly eligible recipients recently signed up, the state expects to pay $531 million in general funds for Medicaid this fiscal year, while receiving a federal match of $2.4 billion [Michelle Rindels, “Nevada Expects to Spend More on Medicaid Than Planned,” Reno Gazette-Journal, 2015.07.20].

Russell Olson and Rep. Leslie Heinemann
“Russ! Those Democrats keep checking my facts! I’m gonna need more money!”

Hmmm… spend $9 million more (1.7%) in state funds, get $1.0 billion (71%) more in federal health care dollars. That’s like the boss saying that if I deposit an extra $690 in my retirement account, they’ll match it with $36,000. I’m of the impression dentists take some math in college, but in case Les is still scratching his head, the answer to this story problem is yes!!!

And what about Rep. Heinemann’s third example, Montana? Oh, my goodness—it turns out that by March, their enrollment was up to 38,000, almost double that first-year projection. Everything’s going to heck, right?

The Department of Public Health and Human Services also announced this week that the State of Montana has already experienced $3 million in savings to the state general fund, and over $37 million in NEW federal dollars invested in communities across the state [Julia Cramer, “Montana Can Expect Continued Economic Benefits from Medicaid Expansion,” Montana Budget and Policy Center: Charted Territory, 2016.03.25].

Um, well, everything’s going to go to heck, right?

Even when the federal share scales down to a 90% matching rate, this is still a good deal for states, because these federal funds generate new economic activity that wouldn’t have happened otherwise. A simple comparison is when someone living outside of Montana visits and spends money in the state. Unlike a state resident choosing to spend a dollar in one area of the state economy versus another, our state economy reaps the benefits of that new out-of-state dollar. As the article points out, for every 90 cents in federal funds to pay for one dollar of new Medicaid spending, the state should expect $1.35 to $1.80 in state economic activity, supporting jobs and increasing tax revenues for state and local governments [Cramer, 2016.03.25].

Les, you’re the fiscal disaster.

Governor Dennis Daugaard chickened out last week on calling a special session to bring affordable health coverage plus $1.383 billion in economic stimulus and 29,500 jobs to South Dakota, so Rep. Heinemann’s op-ed reads more like a campaign pitch to District 8 voters who like voting against South Dakota’s best interest. District 8, figure it out and replace Rep. Heinemann.


9 Responses to Heinemann Fails Fact-Check on Fiscal Impacts of Medicaid Expansion

  1. Darin Larson

    Cory you read my mind on the story. I was just thinking someone needs to write the rebuttal since the governor doesn’t seem up to the task.

    One thing that I would point out is that if it’s too risky to take federal dollars for Medicaid why are we doing it for 1.7 billion dollars of the state budget that the federal government funds already. It seems mighty convenient that the legislature is going to stand on principle now. The horse is out of the barn, the ship has sailed. The Republican legislature loves federal dollars for everything else.

    Now when you talk about 50,000 people getting health care, Republicans suddenly have a whole new take on things. This wouldn’t be because Obama’s name is associated with this program would it? No they wouldn’t play politics and leave 50000 people without health care just to spite Obama. Surely not!

  2. I am tired of people who qualify for VA Benefits and Midicare and other government health programs wanting the rest to do with out health care. I beleive by providing health care saves money long term and keep people in the work force. longer.

    The problems in health care are the insurance companies who make more money on health care than Obama Care Costs. They used the 3 D program for years to keep from paying,

    D_ Delay
    D- Deney

    D death

  3. Sam2, you just described the entire base of the voting public. The reason the old farts do not want others to have insurance is because they worry they will loose their own. We used to have solidarity in our country, now it is every man for himself.

    Henieman whines about the Veterans Choice, he is an idiot. It works very well for me as I have used it several times. Henieman must not be a veteran or if he is, he is not enrolled.

  4. Donald Pay

    Uh, isn’t the Republican Party partly responsible for broken treaties and funding deficiencies? Republicans want to privatize the VA, and are therefore refusing to fund it adequately. Same with the IHS. I haven’t followed all the ins and outs of the Lewis and Clark Water Project, but I suspect Republicans haven’t made that much of a priority. Maybe the fault lies with his party, not the government. He ought to take them to task, not use their inaction to excuse his own inaction.

    I would expect someone in a health profession would see the numbers coming into the Medicaid program in other states and think it was great that these folks are finally getting some medical care. But this dentist looks at the numbers of desperate people and thinks that’s a reason to kick them in the teeth. I’d never ever go to that dentist for any sort of care.

  5. drey samuelson

    This is a perfect example of why I am so grateful that our South Dakota ancestors (and those in many other states, for that matter) had the wisdom to enact the ballot initiative option to go directly to the people when the State Legislature and the Governor refuse to act. This is an issue that South Dakotans of goodwill across the political spectrum need to examine and decide if they want to live with this inaction, with all of its heartless consequences, or change it. People have the power to change these facts, if only they have the will to do so. The singer, Patti Smith, had it exactly right, “People have the power”: https://www.youtube.com/watch?v=pPR-HyGj2d0

    First, folks have to recognize they have it, and then they have to do it.

  6. The numbers don’t lie. Expanding Medicaid makes sense for South Dakota. It is the morally correct thing to do and the state will benefit financially. It is time to put the GOP voodoo dolls away and get down to business.

  7. Mr. Pay, Ohio Republicans, Ohio is the kingmaker, long viewed the VA as a source of corruption that would rival all other departments in the United States government. Warren Harding had done his level best to make that happen. Their view was that no one would dare question the funding or the maneuverability of their corrupted contractors to provide unlimited kickbacks. http://www.burtfolsom.com/?p=2838

    Their dream of privatization would amount to putting all 6 bullets in the gun for the Russian Roulette aimed at the head of all veterans. Here is the solution I think would work. If you are younger than 18 years old, you cannot vote because it is thought you are an idiot. I will not argue that so I would add that if you draw Social Security, you should loose your right to vote for the same reason. Why should the old farts decide the future of the young? I am thinking that the young folks would understand the sacrifice of veterans and also see the fox guarding the hen house makes no sense.

    We know that Rounds is all go for the veterans as a voting bloc that he abuses frequently. The only reason he supports keeping open the medical facility at Hot Springs is for the right wing vote of which there is plenty there. Do we need another medical facility there? We have one, with the new hospital that could be used. The old campus is to costly to maintain as a medical facility so there must be some kind of use for that, including selling it to a private company.

    I say that each of these legislatures that are against the expansion should be investigated to see how many of their family are presently or in the past have used or are using Medicaid in nursing homes and for other purposes. That should be exposed.

  8. Drey, among reforms we should consider in the 2017 Legislature is a measure to move the deadline for submitting initiative petitions from one year before the general election to July 1 prior to the general. South Dakotans need an opportunity to respond to the failure of the Legislature to act in an election year with an initiative of their own.

  9. Lars Aanning

    In 1975 the Senate and House of Representatives of South Dakota issued a concurrent resolution that call for state and federal action to guarantee that the citizens of South Dakota had access to affordable health care and that the medical profession maintained a high level of quality and professionalism. See Defendant’s Exhibit 3, the Senate Concurrent Resolution, 1975 Senate Journal, p. 644-645.