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Daugaard Couldn’t Count on Continued Medicaid Funding, Now Will Trust Feds to Prop up IHS

Expanding Medicaid in South Dakota is a good idea. Governor Dennis Daugaard and Republican legislators have steadfastly blocked this good idea for three years, largely because they can’t bear to sign onto a good idea hatched by President Barack Hussein Obama.

I am glad Governor Dennis Daugaard has finally gotten over his Obamaphobia just enough to propose expanding Medicaid. But this weekend’s article on progress toward the Medicaid/Indian Health Service tradeoff reminds me of a fundamental contradiction in his position. Governor Daugaard and other Republicans long justified their opposition to expanding Medicaid with the argument that we can’t rely on the federal government to continue funding the Medicaid expansion or the Affordable Care Act in general. The Governor appears to have completely abandoned that position, instead basing his entire Medicaid expansion on the federal government’s ability to increase funding for Indian Health Services to take South Dakota’s Indian residents off our Medicaid rolls.

I’m glad the Governor has taken the silly argument of federal funding unreliability off the table and aligned his thinking with the policy practicality under which South Dakota depends on federal dollars for roads, food stamps, water projects, university research, Ellsworth Air Force Base, and maybe F-35s in Sioux Falls. But it seems odd that in this case, the Governor is counting on a federal program toward which Senator John Thune and Rep. Kristi Noem have shown outright fiscal antipathy. Governor Daugaard is trying to expand Medicaid by getting the feds to spend more money on a program that the feds have neglected since its inception.

State Rep. Elizabeth May (R-27/Kyle) remains skeptical:

State Rep. Elizabeth May, R-Kyle, said no matter how much IHS says it plans to change – with or without Medicaid expansion – she’s skeptical that the agency will keep its word. She said she’s seen inadequate care from the agency for years, which has led to death of friends’ family members. And while the agency has long said it would get better, without a financial incentive to improve care options there wouldn’t be any improvement, May said [Dana Ferguson, “Daugaard: Medicaid Talks a ‘Win’ Before Expansion,” that Sioux Falls paper, 2016.01.30].

If we can’t get South Dakota to pay the mere 10% of the cost of Medicaid expansion itself, I’ll settle for the Governor’s plan to have Uncle Sam foot the entire bill by shifting Indian Medicaid patients to a better-funded Indian Health Service. But pardon me is I sit down for a moment to recover from my dizziness as the Governor spins from not relying on federal funding to banking on increased and ongoing funding for a long-neglected black-sheep federal program.


  1. Mark Winegar 2016-02-01

    It takes money to provide medical services and the fed cut back funding and failed it’s responsibility to our first nations. Unfortunately, I don’t anticipate any change in DC which means I don’t expect medicaid expansion to happen in South Dakota until we have a paradigm shift in governance.

  2. larry kurtz 2016-02-01

    South Dakota’s GOP congressional delegation doesn’t want to fund the IHS or the VA and works at cross-purposes with Gov. Daugaard.

    Until Democrats regain the US Senate nothing will change. But you know what? I like the idea of ending both IHS and the VA then offering Medicaid for all funding it by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax.

  3. leslie 2016-02-02

    I like it Larry. I don’t believe a word Daugaard says and Eliz. May mentions her friends but I have a feeling if they are constituents, she still doesn’t work for them. I’d like to be wrong.

  4. leslie 2016-02-02

    ”But we see the future of Kochtopus governance in Rick Snyder’s criminal negligence vis-à-vis the poisoning of the water supply in Flint, Michigan, or in Scott Walker’s war on working people (including university students, workers, and faculty) in Wisconsin. No one can say we weren’t warned. bros

  5. Roger Elgersma 2016-02-03

    Every Republican leader when speaking on ACA says we need to take it apart a piece at a time. Now they want to pass it without paying our share. What else is in it to whittle it down. Will we get less care or discriminate in ways the feds do not. There goal is to destroy it so I can not trust their plan.

  6. jerry 2016-02-03

    There is no way on this planet that the ACA will ever be killed. The republican kabuki dance is so fraudulent it has made me laugh my tail off some 60 times. The republicans are fed much moolah from the insurance companies who have made a killing on the ACA. Stock shares are through the roof in this but the old rubes of the base only know that you should keep your hands off “their Medicare” If the three empty sacks we have in congress can tell you that they have a replacement, then lets hear about it. 60 some times with nothing, that is a record of money spent dancing with the scars.

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