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Medicaid Expansion More Fiscally Doable Than We Thought

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.


  1. Rorschach 2016-05-04 10:14

    Some GOPers are still grieving the loss of their party to the guy Hillary recruited to destroy the GOP party and get her elected. Her plan worked better than anyone ever expected. Some like Troy have moved on to acceptance and are lining up on their knees behind Trump as part of their perceived duty to put party above country. It’s fun to watch, these lamentations and gnashing of teeth, these shameless smooch patootieings.

    That said, the local GOP party is going to continue to beat down the SD poor and SD’s economy just to prove they are still in control of something here.

  2. Douglas Wiken 2016-05-04 10:36

    Perhaps some property tax breaks for the more feeble elderly would help a bit. Funding in home care would be much, much cheaper than the several thousand per month in nursing homes.

  3. leslie 2016-05-05 15:30

    1. when daugaard eventually gets his head out and expands medicaid, then he should be tried for the murder of 30-90 annual deaths of the 55,000 uninsured south dakotans he has let dangle for the last 4 years.

    2. in the meantime, as the ACA stands up to its full height, addiction/alcoholism is going to get handled better in this “warehousing, destroying lives” approach the state still steeps in an old pool of dank bath water of stigma. yesterday NPR broadcast a “must listen and comprehend” piece on addiction.

    3. With respect to cororate nutrition and health, parroting the discredited defense from the Coca-Cola-funded Global Energy Balance Network (GEBN), Warren Buffett unwisely dismissed the health harms of Coke’s sugar water, saying it is just a matter of calories in and calories out.

    Thirty-six leading scientists, including myself, wrote a letter to The New York Times in August 2015 calling the GEBN claims “scientific nonsense.” In fact, GEBN was disbanded shortly after The Times’ reporting disclosed how it was more public relations than science.

    Buffett also said that he consumes about 700 calories a day from Coca-Cola, about a quarter of his daily caloric intake. Good for him and good health to him, but it’s a sure-fire prescription for increased risk of diabetes, heart disease, obesity and tooth decay for the rest of his fellow citizens.

    The U.S. government’s Dietary Guidelines for Americans 2015-2020 calls for individuals to limit their consumption of added sugars to about 200 calories, or 10 percent of a 2,000-calorie daily diet. That translates into about 12 teaspoons of added sugar.

    And Big Soda wonders why it’s compared to Big Tobacco? Like sugar water, cigarettes are cheap to produce, easy to sell and rake in over-sized profits. but don’t look at health consequences.

  4. leslie 2016-05-05 15:33

    rohr-“the guy Hillary recruited to destroy the GOP party and get her elected.” as I said to stumcfar, we didn’t go to the moon either. right.

  5. leslie 2016-05-16 08:41

    republicans cry…whaaaaa…my heaith care insurance premiums went up way because of Obama care.

    in fact, “according to non-partisan sources no state saw rates go up by anything like 76%. The actual –as in “factual” average health insurance premium increase from 2015 to 2016 was 3.2%. In the state of California, statewide we saw rates go up a mere 1.1 percent. atlantic

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