Health care workers discuss Medicaid expansion


SIOUX FALLS, S.D. (AP) — Access to health care professionals and reimbursement options were among the topics discussed at a meeting of a state task force studying the possibility of expanding Medicaid in South Dakota on Wednesday.

The 29-member panel appointed by Gov. Dennis Daugaard is made up of lawmakers, medical facilities directors and other health care workers. The panel is examining the advantages and disadvantages of expanding Medicaid in the state and the best way to implement an expansion. It will give a report to the governor and the Legislature by Sept. 15.

The Legislature earlier this year delayed expanding Medicaid based on Daugaard's recommendation. Daugaard has said he is unsure if the federal government can cover its share of expanding Medicaid, the state-federal program that provides medical care to low-income people.

South Dakota's Medicaid program now covers about 116,000 children, adults and disabled people. Expanding Medicaid would add about 48,000 people, mostly adults without children.

"I think there is room for reform. I think there's a lot of perception that Medicaid is broken," said Department of Social Services Secretary Kim Malsam-Rysdon. She said there needs to be better measures of Medicaid's effectiveness.

"We are not looking for new and unique measures. Let's take out a few key ones and start there and be accountable to the taxpayers," she said.

All health care is being paid for by someone, said Dave Hewett of the South Dakota Association of Healthcare Organizations. Just because a patient is indigent doesn't mean the nurse taking care of him works for free, he said.

"To the extent, these so-called windfalls — they are not windfalls," he said. "They are being picked up by other payers. They are being picked up as a tax — if you will — on people who pay private health insurance premiums."

Under the federal health care law, more low-income people will be eligible for subsidized insurance through online exchanges. States can also expand Medicaid to cover people who are deemed too poor to get the subsidized private insurance.

The expansion would cover people earning up to 138 percent of the federal poverty level. The federal government would fully cover the expansion through 2016. By 2020, the state's contribution would rise in stages to 10 percent.

The task force also discussed the timing of implementation if the Legislature ultimately decides to expand Medicaid.


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