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Medicaid Expansion Advances on Narrow Committee Vote, Needs More Support to Withstand Noem Veto

Senator Wayne Steinhauer’s (R-9/Wall Lake) proposal to beat voters to the punch on expanding Medicaid survived first contact with committee yesterday, but barely. Senate Health and Human Services heard Senate Bill 186 yesterday. They heard diverse proponents ranging from the sponsors of the pending Medicaid expansion ballot question to the Presentation Sisters to conservative Rapid City Mayor Steve Allender say the state should finally buy into the Affordable Care Act’s Medicaid expansion and the two-year extra incentive of the American Rescue Plan. The only opponents were radical conservatives—Americans for Prosperity, the Foundation for Government Accountability, and Governor Kristi Noem’s flunkies in the Department of Social Services—saying that we can’t afford to cover any more poor people’s medical bills.

Yet the vote to send SB 186 to the Senate floor was only 4–3. Steinhauer brought along Republican Senators Arthur Rusch and Erin Tobin and Democratic Senator Red Dawn Foster to say aye, while Republican doctor R. Blake Curd, cranky conservative Jim Bolin, and somewhat reasonable Brookings Senator V.J. Smith said nay.

Extrapolate a 4–3 to the full Senate, and you don’t have the votes to overcome a veto, a prospect raised by the testimony of Noem’s DSS against Medicaid expansion.

Senate Bill 186 is on the calendar for second reading in the Senate today.


  1. larry kurtz 2022-02-15 08:14

    If South Dakota’s policy makers had any cojones whatsoever they’d bring legislation that would compel the medical industry to post the costs for all procedures.

    So if these hospitals are monopolies like utilities are, or even oligopolies in their markets, why isn’t there a voter-elected public commission to regulate pricing? In the Argus Leader Republican State Senator/Dr. Blake Curd accused Avera of being a monopoly.

    Curd brought this problem on himself. Avera is doing what they need to do.

    Core orthopedics left Avera and joined [Sioux Falls Specialty Hospital] and [Orthopedic Institute] taking millions in orthopedic surgery away from Avera. As a result Avera had no choice to start their own ortho program, hire employed orthopedic surgeons and build the new hospital. Once Avera has opened their new ortho hospital they would be insane to pay Sfsh or OI when they can do everything themselves. Avera orthopedic surgeons are just as good as OI. Sanford excluded OI and Sfsh years ago. Markets shift , conditions change. If Avera employees demand to see OI surgeons and have surgery at Sfsh they have 2 options: 1. Pay for it themselves 2. Find another employer who will pay for it.

    Sfsh distributes over $24,000,000 / year to its surgeon owners – tax free. Curd makes money on his distributions, his role as Sfsh ceo (over $400k) as an owner of [Surgical Management Professionals] (who manages Sfsh revenue cycle) as an owner in the service line management company that contracts with Sfsh. It’s no surprise he is leaving.

    [Dr. Larry Teuber]

  2. William Baker 2022-02-15 09:20

    What part of the Govt. Funding Source is the Fed. govt., Giving to states to fund Medicaid Expansion ? (IHS/HHS), why are Native American, SD, legislatures, voting to have IHS/HHS, funding reduced to provide Medical Care funding for there “People”. Former CEO, Brent Phillips, he explained why he thought so, however, he’s a Civil Rights Perpetrator, hence had no 2nd. Thoughts to rob the IHS/HHS/CMS finding..remind a reader of the source of funding that this all happens. Like wise those White Legislators have no Conscious of taking non white money from IHS.

  3. Porter Lansing 2022-02-15 14:33

    Why do y’all think Joe “Steady” Biden didn’t cut off South Dakota’s opportunity to straggle in on the Medicaid expansion opportunity?
    Noem would have cut all low-income people off their food, housing, and medical assistance completely, if she’d had a witch’s chance.

  4. grudznick 2022-02-15 18:00

    President Uncle Joe Biden doesn’t really think as much about witches as grudznick does.

  5. larry kurtz 2022-02-15 18:02

    Thanks blue. It’s not working on the iPhone so will try on the Mac in the morning.

  6. Mark Anderson 2022-02-15 18:05

    OK so people vote in Medicaid. They voted in Marijuana. Kristi canceled it. Canceled the actual vote of the people. So how does she get elected? Is it the shear beauty of her ideas? Her shear beauty? Republican men ARE horny old goats, and the female of the species are wannabes. What else can it be? Maybe Republicans like people suffering? It gives value to their sense of superiority? Who knows?

  7. grudznick 2022-02-15 18:15

    Mr. Bolin might be cranky but golly he’s bested Mr. H in every debate they’ve had.
    Plus he has the second best haircut in the legislatures.

  8. Porter Lansing 2022-02-15 19:28

    One voter out of a thousand in SD know anything about politics.
    – The remaining 999 vote Republican because that vote guarantees racism against Indians, bigotry against low-income people, and disrespect of women.
    – Then they go to the bar and brag that they voted, over a Windsor and water and a joint in the car.

  9. grudznick 2022-02-15 21:16

    Does Dr. Lar Tueber really think the Governor will have to veto this, Lar?
    But perhaps Mr. Steinhauer had it righter than right.
    Yet the libbies could not get it across the line.

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