An area where Governor Dennis Daugaard and the Legislature have more damagingly dithered than grassy buffer strips is Medicaid expansion. Three years in, and we are still denying tens of thousands of South Dakotans access to affordable health insurance, just because a bunch of us don’t like Barack Obama.
Our Medicaid mud-sticking is also leaving our rural hospitals without a valuable financial kick. A new study indicates that South Dakota’s rural hospitals could benefit even more from Medicaid expansion than their big-city counterparts:
In states expanding Medicaid, rural hospitals saw a greater increase in Medicaid revenue than urban hospitals did. City-based facilities save a higher percentage than rural hospitals with the reduction in uncompensated care, though that change “did not translate into improved operating margins for urban hospitals,” the study notes.
…One likely factor: Rural hospitals serve more low-income people — who weren’t eligible for insurance before, but who got covered after the health law took effect. And rural hospitals are historically more likely to operate at a loss than are urban ones. So the chance to see increased revenue is greater than in a city-based hospital [Shefali Luthra, “Lack of Medicaid Expansion Hurts Rural Hospitals More Than Urban Facilities,” Kaiser Health News, 2016.09.07].
The study is Brystana Kaufman et al., “Medicaid Expansion Affects Rural and Urban Hospitals Differently,” Health Affairs, September 2016.
We’ve known expanding Medicaid would help our rural hospitals for years. Yet here South Dakota sits, waiting, as hospitals and sick people suffer.