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Senate Committee Approves Special Medicaid Expansion Fund—Just Don’t Call it “Medicaid Expansion”!

Remember how I said on Thursday that we can probably get the South Dakota Legislature to expand Medicaid if just don’t tell them they are expanding Medicaid? That appears to be part of the strategy Tim Rave is using ease legislators into finally, completely surrendering to Obamacare.

On Friday, Senate Health and Human Services took up Senate Bill 102, one half of Senator Wayne Steinhauer’s (R-9/Wall Lake) two-bill package to expand Medicaid in South Dakota. SB 102 would bankroll the early two years’ worth of extra Biden bucks we would get under the American Rescue Plan for expanding Medicaid into a new lockbox to cover future costs of Medicaid expansion.

Former legislator Tim Rave, whose South Dakota Association of Healthcare Organization is backing the public vote on Medicaid Expansion through Amendment D this fall, spoke in favor of SB 102’s lockbox. Even though SB 102 has Medicaid expansion in its title, calls its lockbox the “Medicaid expansion fund,” and creates a statutory definition of Medicaid expansion, Rave said, “This has nothing to do with Medicaid expansion—separate those topics. This is creating a fund if in the future it would be necessary to have those funds to help stabilize the state’s budget.”

Rave’s flatly counterfactual statement doesn’t help me trust him on Medicaid expansion.

Senator Steinhauer’s explanation of SB 102 to his committee seemed far more straightforward and trustworthy. Steinhauer spoke of Medicaid expansion as an inevitability. He noted that every state that has brought Medicaid expansion to the ballot has expanded Medicaid. (Montanans rejected a Medicaid expansion initiative that included a tobacco tax, but the Montana Legislature then expanded Medicaid.)

Senator Steinhauer expertly rattled off details on the mechanics of Medicaid expansion, noting that South Dakota will receive $52 million extra from the federal government in the first two years courtesy of the extra incentive in the American Rescue Plan Act (he did not say “Biden bucks”) plus over $11M each year in ongoing savings in IHS services, behavioral, and incarcerated treated in hospitals. Steinhauer said it makes sense to bank the extra early windfall and use it to cover ongoing costs, and since ARPA doesn’t earmark the incentive dollars for specific uses, sticking the cash in the SB 102 lockbox for later use is legal.

Senator Jim Bolin (R-16/Canton) was the only member of the committee unwilling to take Steinhauer’s sensible fiscal action. The committee voted 5–1 to advance Steinhauer’s Medicaid expansion lockbox to the Senate floor.

SB 102 is on Tuesday’s Senate calendar. It will be fun to watch how many Senators adopt Senator Steinhauer’s apparent fiscal fatalism in the face of successful liberal policy and how many like Rave will still find it hard to admit that they are advocating the expansion of Medicaid under the venerable and robust Affordable Care Act.


  1. Porter Lansing 2022-02-07 18:01

    Fun with words in SD.
    “This has nothing to do with Medicaid expansion. Separate those words.”
    “This has nothing to do with abortion pills. Separate those words. These are pills that induce a miscarriage. Nothing like an abortion.”

  2. Jim peterson 2022-02-07 19:08

    Hospitals have always backed Medicaid expansion, not because of the extra millions coming to the state but because of the many millions they had to write off. Many very conservative states like Arizona and NorthDakota expanded years ago, South Dakota passed on several hundred million because Legislators didn’t approve of social health care even though they took federal monies that went to themselves.

  3. Porter Lansing 2022-02-07 19:45

    South Dakota legislators rejected Medicaid expansion for one simple reason.

    It came from a Black man.

  4. grudznick 2022-02-07 20:26

    Mr. Lansing, do not judge this Mr. Steinhauer fellow based on his hair. There is a law bill from Mr. Nesiba that prohibits that.

  5. Mark Anderson 2022-02-07 21:31

    Shhhh Cory, just let them lie to save face.

  6. Porter Lansing 2022-02-07 21:56

    grudznichs Are you drunk, again? You make no sense more often than not, anymore.

  7. larry kurtz 2022-02-08 09:57

    The military loves TRICARE, veterans mostly like the VA and most Native Americans won’t support a copay because We the People are responsible for their medical care so Medicaid for all is the real choice of progressives.

    Recall former Montana Sen. Max Baucus threw President Barack Obama’s pick for Health and Human Services Secretary, former Senate Majority Leader and fellow Democrat Tom Daschle, under the bus during a pre-confirmation quarrel in 2009. Daschle was widely expected to push Congress toward a Medicaid-for-all health care plan in the weeks before Big Pharma-backed Baucus soundly rejected single-payer medical insurance and guided the passing of what would become the Patient Protection and Affordable Care Act.

    Obama later admitted he “screwed up” by pushing Timothy Geithner’s confirmation as Treasury Secretary first in a effort to reverse the economic catastrophe left by the previous administration. Daschle withdrew after Obama put off his confirmation hearing and after Baucus stabbed Daschle, the American people and the new president in the back.

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