EXPANSION- A gradual rise, not a flood, from Medicaid expansion

MM Curator summary

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[MM Curator Summary]: SD Medicaid expansion uptake is going slowly, but officials don’t want to reduce the budget just yet.



Clipped from: https://www.keloland.com/news/capitol-news-bureau/a-gradual-rise-not-a-flood-from-medicaid-expansion/


PIERRE, S.D. (KELO) — People didn’t immediately rush to apply for services when eligibility for South Dakota’s Medicaid program expanded July 1, but the numbers of adults enrolling in the months since then have gradually gone up, according to the leader of the state Department of Social Services that oversees it.

Are SD children well? Report reveals status

Cabinet Secretary Matt Althoff told the state Board of Social Services on Tuesday that the program was funded for this first year to handle up to as many as 57,000 new adult enrollees, as eligibility expanded from 100% to 138% of the federal poverty level. For a one-person household, the maximum income to qualify is currently $1,677 a month.

So far, applications have flowed steadily into DSS offices but there’s been no flood. Data for June showed 43,953 adults and 79,590 children eligible, as COVID-19 eligibility wrapped up. Come July and voter-approved expanded eligibility, the numbers rose for adults to 44,965, while the children fell back to 75,760. The pattern continued in August, with 46,187 adults and 74,546 children; and again for September, with 47,445 and 73,436.

“I’m really grateful they didn’t all show up on July first,” Althoff said, referring to the 57,000. “We’re far short of that.” He estimated the expanded-eligibility group would reach 11,000 to 12,000 for the first year at the current pace. “But,” he added, “steadily increasing every week.”

Althoff said he spoke about the situation Tuesday morning with the state Bureau of Finance and Management and said other states that went through eligibility expansion have suggested South Dakota wait on downsizing any projections, because they eventually reached the estimates in their states.

“It is way, way, way too early to abandon ship on our 57,000,” he said.

The department eased its way in, delaying acceptance of claims for professional medical services by a month and claims for hospital services by about two months. The department’s deputy secretary, Brenda Tidball-Zeltinger, said the most immediate claims were for pharmacy services. She noted that pharmacy and dental services were the first to receive reimbursements.

“Now we’re starting to see some of those clinical visits,” she said, and hospital services will start to show up soon.

One thing Althoff described as “uncanny” was how many of South Dakota’s expansion enrollees filed an immediate claim.

They appear to be enrolling when they need medical care,” he said.