Preserve Legislative Power, Save Campaign Cash: Steinhauer Offers Medicaid Expansion Bill for Amendment D Withdrawal

Evidently ballot measures can coax some Republicans to support Medicaid at least as much as they support marijuana. Senator Wayne Steinhauer (R-9/Wall Lake) went to breakfast and promised to file bills to expand Medicaid… if the hospital lobby agrees to pull Amendment D from the ballot:

“There are words in that thing that don’t give us the flexibility we want,” he told a crowded room of constituents and colleagues at the Hilton Garden Inn South in Sioux Falls. “And we have to do this right.”

Steinhauer, chair of the state Senate’s Health and Human Services Committee, was specifically referring to language in the initiated amendment proposed to the state Constitution that would require the state’s Medicaid funding formula to consider all Medicaid recipients equally and bar the state from implementing a work requirement for recipients of specific demographics.

Instead, Steinhauer wants a bill passed with plain language expanding Medicaid without detailed stipulations. It would also provide for the state to scale back its Medicaid program should future Congresses reduce the rate at which the federal government shares Medicaid costs with state governments.

…”If we pass it, at the very least, the health systems would stand down,” he said. “Why spend millions on something that’s already passed?” [Joe Sneve, “Senator Seeks to Withdraw Ballot Measure in Exchange for Legislative Action on Medicaid Expansion,” Sioux Falls Argus Leader, 2022.01.06].

Naturally, Senator Steinhauer wants to keep the people from putting Medicaid out of his meddling reach. If voters pass Amendment D in November, legislators can’t water it down or repeal it. If he can get his colleagues to swallow the bitter pill of ObamaCare (sweetened, of course, with hundreds of millions of federal dollars from President Biden, windfalls to which Governor Noem herself has said we durst not say no!), Senator Steinhauer would keep Medicaid expansion in the hands of the Legislature, which could then tinker, sabotage, or sink the program at will. Yeah, it’s still ObamaCare, but at least it’s our ObamaCare.

Senator Steinhauer is prepared to test the thesis I’ve wondered about since the South Dakota Association of Healthcare Organizations, led by influential former Republican Senator Tim Rave, announced its petition drive to expand Medicaid: do the big hospitals really want to put Medicaid expansion to a vote of the people, or did they launch their petition drive to push the grassroots Medicaid expansion group Dakotans for Health off the field, keep the Medicaid issue entirely in their hands, and arm themselves with an approved ballot measure not to empower the voters but to strengthen their own position as they lobby the 2022 Legislature for the bill they really want.

Senator Steinhauer points to one reason the hospitals might prefer a Legislative solution to a statewide vote: they’d need to spend millions on a campaign against the Americans for Prosperity plutocrats who are already spending big money to rig the election process against initiative supporters and prevent further victories for the Affordable Care Act and the common man. The hospitals could get most of what they want at far less cost by laying out a few wiener platters next to an open bar at the Ramkota this winter.

Watch Steinhauer’s bill list; he’s not prime-sponsoring anything yet, but he has until Groundhog Day to put together his bills and tempt his colleagues and the hospitals to accept a compromise that preserves both groups’ power and keeps us meddling voters out of the way.