As the 2013 South Dakota legislature opens, state Democrats are calling on Governor Dennis Dauagaard to speedily adopt the federal government’s offer to effectively pay for a Medicaid expansion that would insure as many as 48,000 additional South Dakotans:
South Dakota Democrats will push to have the Legislature quickly expand Medicaid to cover thousands of additional low-income residents, but Republican Gov. Dennis Daugaard and GOP lawmakers say they need more time to study the potential costs.
Senate Democratic leader Jason Frerichs said the Medicaid expansion, which is part of the federal health care law, would cover an estimated 48,000 South Dakotans.
“It needs to be done, and we hope it will happen,” said Frerichs, of Wilmot. “In most cases, these folks are not covered right now by some type of health insurance.”
But House Republican Leader David Lust, of Rapid City, said lawmakers must first find out who would be covered by an expansion and, most importantly, whether the federal government can afford to pay its share. Much of the next legislative session, which opens Tuesday, will be spent seeking that information, he said.
“Until there’s more information, more clarity, I think it would be irresponsible for anyone to reach a conclusion as to whether or not to expand Medicaid,” Lust said.
When somewhere between 71,000 (state numbers) and 105,000 (U.S. Census Bureau) South Dakotan are uninsured, the Medicaid expansion is a pretty huge deal. But Governor Daugaard declined to mention it even once during his State of the State address today (though, on an unrelated but positive note, he did appear to embrace the Criminal Justice Initiative’s recommendations for reducing SD’s over-incarceration crisis, at least in word). Just calls for “more information, more clarity.”
How about this for more information: if we were to expand Medicaid under the Affordable Care Act, the state would spend $5.6 billion between 2014 and 2022. Meanwhile the federal government would pump $11.4 billion into the state to cover the rest, according to a Kaiser Family Foundation study, including paying for 100% of the expansion over the first three years. If we decline all that federal money, however, we’ll still spend $5.5 billion. And actually, due to fewer uninsured emergency room visits, the cost of which would still be borne by the state, it’s likely that the expansion would actually save South Dakota money, even in the short run.
In my eyes, the reason Republicans are calling for “more information, more clarity” is simple: because the information is already there, and it positively demands that South Dakota accept this expansion. But the thought of expanding a program that already far outclasses anything the private sector has to offer is anathema to the bankrupt free market orthodoxy so many of our leaders remain in thrall to.