South Dakota Medicaid Expansion Breakthrough Forthcoming?

South Dakota Governor Dennis Daugaard appears to have made significant progress in the quest to expand Medicaid coverage in the state.

As he spoke in Pierre at his budget address on Tuesday, he hearkened back to previous years when the Governor was hesitant to expand Medicaid. “I haven’t said, ‘Never.’ I have always said, ‘Not now.’ We just didn’t have the money.”

Daugaard explained that the time might be closer to now. The Governor’s office has been in talks with different entities such as the Department of Health and Human Services (HHS) which have led to a more fruitful dialog about expanding Medicaid. “It’s because of conversations among the State, the federal government and South Dakota Tribes about the way we provide health care services and finance them for Native Americans.”

State Senate Minority Leader Billie Sutton (D) of Burke says the plan does have merit. “HHS has developed a white paper with some strong language that they are really considering this as treaty rights for Native Americans. That would free up $67 million for the State. It would be a no-brainer to expand Medicaid at that point.”

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State Representative Lee Schoenbeck (R) of Watertown is quite skeptical of the proposal. “The State’s saying, ‘Ha ha! We’ve figured this out. We’re going to get the Feds to pay for it.’ If you think that gimmick is going to be a long-term solution and fiscally sound, you’d have to be nuts.”

The plan hinges on Medicaid eligible Native Americans seeking care through Indian Health Services which would get fully reimbursed at the federal level, in turn taking some burden off the state.