Gov. Dennis Daugaard decided against expansion last year, instead saying he wanted a committee to study the issue thoroughly and report back the advantages and disadvantages of making the move. That committee has wrapped up its work and is finalizing its report for Daugaard and the Legislature this month.
At stake is health care coverage for an estimated 48,000 now-uninsured South Dakotans. If the governor decides not to expand, 22,000 of those still would be able to buy coverage from the new federal exchange that should start up in 2014. The other 26,000 would not be eligible to buy from the exchange because they are too poor to qualify.
Under the statute, which, like it or not, is the law of the land, the federal government will pay the total cost of medical service to the new Medicaid-covered population for three years. After that, the proportions will shift until the federal government’s payment is 90 percent by 2020.
There certainly are legitimate issues involved in this expansion. There will be some significant additional administrative cost — at least $9.5 million, by some estimates. And there is genuine concern about the federal government’s ability and desire to continue funding as spelled out past 2020.
However, these concerns should not stop us from expanding coverage to the working poor in our state now.
Medicaid costs are a perennial issue in the state Legislature. Increased Medicaid demands strained the state budget during the recession.
As a state, we traditionally have shied away from broadening eligibility beyond children, disabled and elderly residents. This expansion would fundamentally change our approach and bring working adults under Medicaid coverage. These working poor families, who are uninsured now, would be able to get regular health care coverage, meaning fewer emergency room visits, the cost of which is spread to insured individuals.
What we ultimately decide in South Dakota says something about us as a people. Is the decision on Medicaid expansion about improving the lives of many working poor families? Or is it about the dislike of the Obama health care reform act or a rejection of the notion of higher federal government involvement in our affairs?
We ask our Republican governor to do more than hold his nose and say yes here. We urge Daugaard to step beyond the political comfort zone to lead a reasoned discussion on this issue in the Legislature and across the state. He can do that.
Twenty-three states already have agreed to expand Medicaid, including North Dakota, Minnesota and Iowa. In South Dakota, the state medical association, the hospital association and several social service organizations support the expansion.
This move will allow thousands of uninsured families to have their health care needs covered. Healthy families and fewer sick residents translate to happier homes and more productive workplaces.
That’s reason enough to act now.
— Sioux Falls Argus Leader