Rep. Lee Schoenbeck (R-5/Watertown) is looking at Medicaid expansion from a partisan political perspective, so why don’t we?
In his December 8 budget address, Governor Dennis Daugaard justified expanding Medicaid in return for the feds’ fully funding health care for Indians in South Dakota with this cost-benefit analysis:
Now this is a complicated decision, and we are going to have to all weigh the positives and negatives. In my mind, the opportunity to end this longstanding IHS reimbursement issue, to gain coverage for more South Dakotans, to improve the health care for Native Americans, to save money for counties and Medicaid providers, and to potentially save millions in state dollars, I believe those things outweigh the negatives [Governor Dennis Daugaard, FY2017 budget address, Pierre, SD, 2015.12.08].
Understated in that cost-benefit analysis is the fact that the Governor’s IHS–Medicaid trade-off by itself, without taking into account the incredible job-creating stimulus impact, actually saves the state budget $158 million over the next five years and $10 million each year after that (all figures in millions of dollars):
|Fiscal Year||SD savings by shifting costs to IHS||SD cost to expand Medicaid||Net SD savings|
Saving money and improving health care aren’t enough for Rep. Schoenbeck, who says the Governor (who won re-election last year by the largest margin in South Dakota gubernatorial history and has a vast pile of unspent political capital) has failed to include the political cost to his party in his cost-benefit analysis of Medicaid expansion:
I am concerned about what this Medicaid/Obamacare expansion will mean for both our state, and our party. If expanding the welfare rolls by adding 10% of our state’s population passes in an overwhelmingly GOP dominated legislature, there will be a lot of us asking: what’s the difference? And that will be a future challenge for the GOP in organizing and recruiting.
I would really be surprised if it didn’t affect the enthusiasm of the people we ask to go out and organize and sell tickets to our large network of Lincoln Day Dinners [Rep. Lee Schoenbeck, blog comment, Dakota War College, 2015.12.23].
Daugaard surrenders to Obamacare, right wing stays home—there’s the Republican agony we were expecting.
Governor Daugaard has affirmed the reasons that Democrats have been giving to expand Medicaid for the last three years: we can save money and save lives. It’s the right thing to do. The fact that Medicaid expansion could make arch-conservatives like William and Anne Beal stay home from the polls and not write checks to Schoenbeck and other Republican legislative candidates is pure gravy. I don’t need gravy with my potatoes, but if that’s what right-wingers want to make it, then that’s all the more reason for the Obama Administration to make the IHS–Medicaid trade-off work and for our Democratic legislators to line up 100% behind the Governor’s plan.