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South Dakota Leads Charge to Purge Medicaid Rolls

Last November, voters ordered South Dakota to expand Medicaid under the Affordable Care Act starting July 1. But CNN reports that South Dakota is one of five states leaping at the chance to boot people off Medicaid this month:

Millions of Americans are at risk of losing their Medicaid coverage in coming months, but residents in Arizona, Arkansas, Idaho, New Hampshire and South Dakota will be the first to bear the brunt of the terminations.

States have been barred by Congress from winnowing their Medicaid rolls since the Covid-19 pandemic began. That prohibition ends on Saturday, and some states are moving much more swiftly than others to kick off those deemed ineligible for the public health insurance program for low-income Americans.

…Nearly 152,000 residents were enrolled in Medicaid in January, an increase of more than 30% from March 2020, according to the state’s Department of Social Services. But more than 22,000 people appear to be ineligible currently.

The agency said in an FAQ that it will prioritize reviewing folks who are most likely to be ineligible because they no longer meet a coverage group or their income has increased, among other reasons [Tami Luhby, “These 5 States Will Be First to Kick Residents off Medicaid Starting in April,” CNN, 2023.04.01].

DSS says reviewing Medicaid eligibility and booting people who no longer qualify will take nine to twelve months. DSS promises to notify folks it boots that they may requalify under Medicaid expansion in July, but Jen Dreiske of South Dakota Voices for Peace asks, why not just wait until July to start the review and protect low-income South Dakotans from up to three months of going without health insurance?

…that three-month gap can wreak havoc on low-income residents’ health, said Jen Dreiske, deputy director of South Dakota Voices for Peace, which is working with the state’s immigrants and refugees to inform them of the unwinding. These folks may have to go without their heart medication or their cancer treatment. They may also be afraid to go to the doctor because of the cost.

“Why can’t we just wait until July 1?” Dreiske said. “Our concern is that people are going to get sick or die because they’re not going to be able to access the health care that they so desperately need” [Luhby, 2023.04.01].

I know our state economy has been faltering, but we heard projections of increased tax revenue all through the just-completed 2023 Legislative Session. Surely we have some fiscal wiggle room to cover a few more Medicaid recipients for three more months, especially when that coverage is an investment in keeping workers healthy and on the job.


  1. Eve Fisher 2023-04-01 09:35

    “The poor can never be made to suffer enough.” Jimmy Breslin
    God knows that’s true in South Dakota.

  2. larry kurtz 2023-04-01 10:02

    Wendy Soulek is chief operating officer for and heir to Lantis Enterprises—a Spearditch, South Dakota company operating some 21 long term care centers, 6 Alzheimer’s Units, 14 personal care/assisted living centers, and 5 home health agencies including facilities in Montana.

    Because of Republican cuts to Medicaid reimbursements ten long term care properties closed in Montana last year and in October Lantis shut their fifth home including the Friendship Villa in Miles City and Rocky Mountain Care Center in Helena. Lantis shuttered the Glacier Care Center in Cut Bank and closed Beartooth Manor in Columbus on January 7.

  3. All Mammal 2023-04-01 11:07

    Best economy in America. An article I read in the AP had all the states’ main industries listed with stats and all that good stuff. NY, of course, had Entertainment, Finance, Tourism, Start ups, Ship yards, everything you can think of. Other states had productive lists too. SD’s list said: Retail, Medical, and Finance. Great career options. Work at Walmart and get sick while foreigners hoard fat stacks in Sioux Falls trusts. At least KN is impressed.

  4. O 2023-04-01 12:31

    Come on, when the Governor said, “Best economy in America,” you all know she wasn’t talking to “those” people.

    We really have become “two Americas”; although it is easiest to point to the red-blue chasm, the real division is the haves and have-not’s. The investor class and the worker class. The sooner “real America” gets it through their thick heads that they are not the investor class and stops voting to protect the interests of the investor class to the detriment of their own interests, the scales will be tipped in the wrong direction.

  5. O 2023-04-01 12:33

    . . . the sooner the scales will stop tipping in the wrong direction. [edit]

  6. Mark Anderson 2023-04-01 15:42

    There are so few trans to punish Cory. The Repubs need some real red meat in their teeth, the poor are always there for them.

  7. grudznick 2023-04-01 18:13

    Purge the rolls.

  8. jakc 2023-04-01 19:58

    I imagine that if you talk to a rural hospital administrator (are there any left in SD?) or an economist, this is a bad idea for the SD economy. Bad, but popular. The consequences don’t matter if you get the votes for the image I guess.

  9. Mark Anderson 2023-04-02 08:30

    Dusty Johnson sticks it to the poor. On this, on SNAP all the while morally proclaiming the only way out of poverty is by work. South Dakota seems to have the lowest common denominator of representation. The only way out of that is by voting for reality instead the dusty trail of ignorance and stupidity.

  10. 96Tears 2023-04-02 09:47

    If the federal rules drop people from the Medicaid rolls because the COVID emergency has slackened, then dropping those allocations is appropriate. That isn’t what is a bother. It’s the spirit of Noem’s desire to lead the nation in being a jerk to less fortunate people that is galling and her damnable lies about the state’s economy that are so evil. She won’t blink an eye about shuttling hundreds of thousands in COVID relief and government largesse to her family members. She is evil, as her actions and slothfulness consistently remind us. Her reward will eventually be a trainload of bad Karma that she’s bringing upon herself.

  11. larry kurtz 2023-04-02 18:10

    Mrs. Noem’s actions in most social justice cases are tinged with stingy racism stirred with a dash of cruelty and baked with spite.

  12. John 2023-04-02 18:15

    Folks of a certain age . . . consider this piece from Wired.

    grud, republicants . . . nothing to see here. You should continue with your “Noem-care”, bleeding, and leeches healthcare to further bend the life expectancy curve. Please.

    This test is the real deal, no Elizabeth Holmes fraud. Recall that the founder of Illumina was key in gene sequencing and therapies (think aka CRISPR). Ilummina spun off Grail so that Grail could assume the risks of developing the test, protocol, approvals. Once successful, Illumina tried to repurchase Grail. Regulators blocked the purchase citing monopoly and anti-trust. From the Grail website Q&A, it’s similar to ordering a DNA test kit, but analyzes two blood tubes, about 20ml or 1 1/2 tablespoons (for you non-STEM heathens). Turn around is about 2 weeks. Cost is $949. It’s not yet covered by Medicare. One company covers the test via Medicare Part B . . .


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