Medicaid expansion faces hurdles in South Dakota

MM Curator summary

[MM Curator Summary]: The 2 ballot initiatives have been consolidated, but a pesky $456M annual state funds additional costs estimate still hangs out there.


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Facade of South Dakota Capitol building in Pierre.

Paul Brady Photography / Shutterstock

(The Center Square) – Zach Marcus of South Dakotans Decide Healthcare is confident South Dakota voters will approve Medicaid expansion in November. 

Ask him why and he will quote numbers he says were given to him by the state’s Legislative Research Council. 

“Forty-two thousand, five hundred South Dakotans are currently stuck in the coverage gap, right?” Marcus, the campaign manager for the organization, told The Center Square. “They’re working hard but still they’re stuck making too much money to qualify for Medicaid, not enough money to actually afford health care.”

And there’s another number. Medicaid expansion would bring back $1.3 billion in federal funding to the state, Marcus said. 

Until earlier this week. South Dakotans Decide Healthcare and Dakotans for Health both had Medicaid expansion measures on the ballot. The groups have joined forces in a grassroots effort to get the measure passed. 

“We are grateful to the 24,000 South Dakotans who signed our petition, and the hundreds of South Dakotans who worked tirelessly to get Initiated Measure 28 on the ballot,” Rick Weiland, co-founder of Dakotans for Health, said in a news release. “After conversations with South Dakotans Decide Healthcare members, we have agreed that the best path forward to accomplishing this goal is to join efforts behind one campaign.”

The groups have an adversary in Gov. Kristi Noem, who has staunchly opposed Medicaid expansion. Noem’s administration did not immediately return a message seeking comment. But when lawmakers discussed passing Medicaid in February, a member of Noem’s administration said it would be costly. 

The Department of Social Services would need an additional $456 million a year in ongoing taxpayer funding, said Laurie Gill, the department’s secretary. The department would need an additional 64 full-time employees, she said.

“This growth of the program is out of line with our charge to be fiscally responsible,” Gill told the South Dakota Senate Health and Human Services committee

The Medicaid expansion effort has broad support from South Dakota’s health care community. Among the groups backing the amendment are the American Cancer Society Cancer Action Network, AARP South Dakota, South Dakota State Medical Association, Avera Health, Monument Health, Sanford Heal and the American Heart Association

South Dakota is one of 12 states that has not expanded Medicare. 


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