SD lawmakers exploring Medicaid expansion


PIERRE, S.D. (AP) — South Dakota lawmakers, including leaders from both parties, announced Wednesday they are continuing to seek more information about the possible expansion of Medicaid.

A group of 19 lawmakers said they have formed a committee to learn more about the advantages and drawbacks of expanding Medicaid. The committee, which includes the Republican and Democratic leaders of both legislative chambers, requested that a special hearing be held by a joint meeting of the House and Senate committees on Health and Human Services.

Republican Gov. Dennis Daugaard wants the state to delay a decision on whether to add thousands of people to the state-federal program that pays medical bills for low-income people. He has said he is uncertain the federal government can keep its promise to pick up most of the cost of the expansion, which is part of the national health care overhaul.

House Democratic Leader Bernie Hunhoff of Yankton said the group's goal is to make sure lawmakers hold a thorough discussion on the Medicaid issue. Lawmakers need to explore whether it makes sense to take steps now to expand Medicaid or wait a year, he said.

"It will be expanded at some point. The only real question is when," Hunhoff said.

House Republican Leader David Lust of Rapid City said he doesn't know if this year's Legislature will decide to expand Medicaid. An expansion would depend partly on whether the state can afford it when next year's budget is put together late in the legislative session in March, he said.

"We'll see where it goes as we get to the end of session," Lust said.

The state's Medicaid program covers about 116,000 children, adults and disabled people, or about one in every seven South Dakotans. If the state decided to expand eligibility, an estimated 48,000 people — mostly adults without children — would be added to the program.

People with lower incomes — those earning up to 138 percent of the federal poverty level — would be covered by a Medicaid expansion. The federal government would pay all expansion costs through 2016, but South Dakota would also face some additional costs in administrating a larger program.

Daugaard has recommended against expanding Medicaid now because he's uncertain that the federal government can afford to continue covering 90 percent of the cost after 2020.

Daugaard also wants federal officials to give the state flexibility to add only those earning less than 100 percent of the poverty level to Medicaid. He said those earning more than that qualify for subsidies to buy private insurance.

Some lawmakers favor expanding Medicaid because uninsured people now delay getting medical care until they are very sick and go to hospital emergency rooms. Because they cannot afford expensive emergency care, hospitals and clinics have to charge insured patients more to offset losses in charity care.


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