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Knobe Says Put Medicaid Expansion Back on Table…

…Heidelberger Offers Thune Interim Plan to Soft-Land ACA Repeal

The rise of Trump may have made Governor Dennis Daugaard throw in the towel on Medicaid expansion, but Rick Knobe isn’t so easily cowed. Knobe, who pushed for Daugaard to call a special session on Medicaid expansion last summer, says there’s still plenty of time for South Dakota to cash in, literally and morally, on this useful program:

…it is going to take the new administration months to get their feet on the ground. You also know they are NOT going to be able to scrap the Affordable Care Act and start over, and any changes in Medicaid will take equally as long, leaving all of us in limbo. Not a good place to be.

I urge you to change your position. You have invested much time and energy. That time and energy has given hope to the many poor people in this state, who are craving leadership and truly need assistance [Rick Knobe, “Disappointed With Governor Daugaard,” KSOO Radio, 2016.11.18].

Indeed, our Führer probably can’t make the ACA go poof on January 20, and any replacement program may not kick in until 2019. Even a couple years of coverage under expanded Medicaid would do tens of thousands of South Dakotans, not to mention our slumping state economy, a world of good.

Whether the Trumpist Party is at all worried about Medicaid beneficiaries remains to be seen. But Senator John Thune acknowledges that the transition period between ObamaCare and Trump-Doesn’t-Care will require some sort of interim coverage program for folks on the ACA exchanges:

Well, I think that there will have to be a plan in the interim that takes care of people who are on the exchanges today. And we’ve always assumed that there would be a transition period where if, in fact, it is repealed, that it can be replaced with something better. And that – that may take a certain amount of time, but the sooner the better [Senator John Thune, interview with Steve Inskeep, “Sen. John Thune on the Republican Party’s Legislative Priorities,” NPR: Morning Edition, 2016.11.18].

Hey, Senator Thune! Need interim health insurance for 12.7 million ACA exchange customers? There’s a solution staring you in the face, a cost-effective insurer currently taking care of nearly 56 million Americans. It’s you—er, us, the American people—via Medicare. Rescind every ACA exchange policy, transfer all exchange policyholders to Medicare, and have Uncle Sam guarantee their health coverage until the Trump Administration enacts its Conservative Affordable Care Act… whose acronym will summarize what people will think of it after enjoying Medicare.

Remember, back in 2015, Donald Trump said he wouldn’t cut Medicare. Trump affirmed the effectiveness and popularity of our greatest social insurance program: “Abolishing Medicare, I don’t think you’ll get away with that one. It’s actually a program that’s worked. It’s a program that some people love, actually.” So, given our President-Elect wouldn’t renege on such a clear promise, we can count on Medicare not only to take care of Grandma and Grandpa but also provide robust stop-gap coverage for millions of Americans who would otherwise be left out by the Trump-publican repeal of the Affordable Care Act.


  1. jerry 2016-11-18 17:56

    Mr. Knobe is spot on. ACA will not go away, ever. The profits and the folks involved with it will never allow that. Daugaard has proven he is a useful tool for the Pence when the time comes for further involvement, until then. We loose a billion buckeroos. Go Knobe!

    When you see the connection between the owners and the Trump family, you get the idea.

  2. Dale B 2016-11-18 18:01

    PPACA will not be repealed. Not in part or in full. Right not team trump is trying to thin out the constitutional caucus’ impact in the House and Senate.

    Daugaard only cares about Medicaid expansion is so he can enrich his cronies. The right question to ask is why is there no longer any money in Medicaid expansion, there you will find your answer.

    A hint to this answer has appeared in how the GOP wants to “fix” PPACA. At the top of this list is waiving or doing away with the fee/fine for people who dont have insurance. Figure out the link between waiving the fee/fine and no money in Medicaid expansion you will figure out what the future of PPACA is.

  3. mike from iowa 2016-11-18 18:20

    Been hearing that Paul Ryan couldn’t find 2.5 billion for ACA high risk pool last year so companies raised their rates before the election. Now with the election successfully stolen, Ryan has magically found 25 billion for the high risk pool for his plan to replace ACA. Dang coincidences.

  4. Porter Lansing 2016-11-18 18:49

    Trump-Doesn’t-Care ….. good one.

  5. jerry 2016-11-18 19:05

    mfi, the 2.5 is going to go to tax cuts, not high risk pools. That field has been plowed already, including right here in South Dakota. Will not work, will never work proven too as well.

  6. MOSES6 2016-11-18 19:20

    No use to talk to the man in the empty suit.I doubt if he could rub two sticks together to start a fire.

  7. mike from iowa 2016-11-18 19:33

    Good link, Jerry. Thanks. As for healthier and younger people not joining up, wingnuts did an all out blitz telling younger people not to sign up. hoping to kill ACA before it got off the ground.

    Wingnuts plan for insurance are mostly contingent on people staying insured (continuous). All insurance cos have to do is drive up their premiums so people drop insurance and then they can’t get re-insured with pre-existing conditions.

  8. jerry 2016-11-18 19:42

    Insurance companies must present a plan to the state Department of Insurance before they can raise rates. They must show that 80% of the premium collected goes to pay claims. When they show that, the state then examines and makes the final decision on if they will honor the request. In the olden days, you are correct, insurance companies pulled rates right out of their nether region. No more of that thanks to the ACA that Democrats put through for the good of all. Bless their little pea pickin hearts.

  9. jerry 2016-11-18 20:27

    Sadly, here we are. Take a look at why Daugaard is a fool. Go down the map county by county and see how fat and sick we are. These are Trump supporters, barely able to walk across the room to turn on the tee vee and get a handful of cookies. These are the medical claims that drive insurance costs. You betcha, put all of that into a Medicaid block grant and see how far it will go, then add in the nursing home stays.

    When your mind is toxic from hyperglycemia, you get angry right quick like and you also get a little paranoid. In short, folks with diabetes have cognitive impairment. These folks are not idiots, they are literally mentally sick and they vote overwhelmingly for Trump. They tend to see Trump as one of them, fat and sedimentary. When Mitt Romney ran, he did not get the vote from this group that Trump got. It is interesting that the more you tend to be inactive, the more you support Trump.

  10. Chip 2016-11-18 21:47

    Republicans have had six years to come up with something to fix Obamacare. Nothing so far. I wouldn’t expect much.

  11. Porter Lansing 2016-11-18 22:02

    Republicans don’t want to fix Obamacare. Republicans want to allow the billions of dollars paid into Social Security and Medicare to get into the hands of hedge fund managers, who’ll get commissions every time they invest it and then reciprocate with campaign donations.

  12. Don Coyote 2016-11-18 23:42

    @Chip: Let’s review. Republicans have only controlled both houses of Congress for two years. Even still the House managed to send ACA repeal legislation six times to the Democrats in the Senate to have it arrive DOA. In January the Republican House and Senate sent repeal legislation to Obama and it was vetoed. They even tried an override but of course there weren’t enough votes. It hasn’t been for the lack of trying but the Narcissist in Chief dearly either wanted to salvage his tattered legacy or to use the failure of ACA as the means to the end …. single payer. Ooops, election really do have consequences.

  13. Darin Larson 2016-11-19 00:07

    Yep, Coyote, Republicans have passed repeal of Obamacare what? 66 times in the House or Senate. How many times have they passed a plan to replace Obamacare? Zero times! They had to kill it before they would know what their replacement plan would be. Still waiting on that plan . . . Survival of the fittest or richest, as the case may be?

  14. mike from iowa 2016-11-19 07:20

    Wingnuts have always had an ACA replacement plan-hurry up and die w/o insurance.

    Since wingnuts didn’t control the senate they settled on obstructionism to prevent America from moving forward. Wingnuts want America to fail so they can turn the clock back hundreds of years to where whitey wingnuts controlled all aspects of everyone’s lives, especially Blacks and women.

    Wingnuts suck as a species and are de-evolving-headed back to the tree from which their ancestors came.

  15. jerry 2016-11-19 08:47

    Then, by all means, proceed. Let Mitch kill the bill root and branch. Immediately. The Black Narcissist in Chief is moving on up Coyote, so now, ya got the white boy with the same moniker. Just you fellers there to do your thing. You already have the papers done, just change the date and your in. There should be no drama and even your drama queen, here in South Dakota, should be able to spirit it through as promised. The ACA is here to stay. Medicare for the elderly and disabled is on its way out, with Social Security to follow. You should be proud Coyote to have played such an important part in screwing yourself for your future. Like all bubbles, there will be a short gain and then, you realize that you are the victim of a hoax. Jokes on you and the rest of us, with the rich laughing their arse’s off at your gullibility. Grab your smoke wagon and commence the shooting of self’s foot.

  16. Chip 2016-11-19 12:18

    Sorry Mr. Coyote, but you don’t have to actually accomplish anything to make your intentions known. Ask your Fraud-in-Chief elect. It’s all too convenient on the other hand to blame Obama or Democrats for your lack of solutions. There are a plethora of open mic’s and cameras on Capital Hill, not to mention the vast right wing media outlets available to outline your plans to ‘fix’ Obamacare. I’m looking forward to watching Republicans dance their way around this.

  17. Laurisa 2016-11-19 17:41

    Apparently there are people who think that Thune (and Rounds and Noem, for that matter) actually cares whether people have health care or not. He’s more interested in everyone being able to have as many guns as they want, however they want and wherever they want than he is in them being able to handle any injuries those guns cause without going bankrupt and losing everything they have. As long as he and his compatriots have their Cadillac federal health care paid for by those of us to whom they would deny that very health care, he does NOT care whether the rest of us do or not. And neither do Rounds, Noem, or the vast majority of the so-called “pro-life” state legislature.

  18. leslie 2016-11-19 22:17

    perhaps a strong dem governor candidate can start Medicaid expansion push right now and force noem to do some heavy thinking for her run at republican state NO. 37 for governor.

  19. caheidelberger Post author | 2016-11-20 18:55

    Agreed: a Legislature truly dedicated to the proposition that all life is sacred would put a much higher priority on universal health coverage than on universal gun-carrying.

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