It’s unlikely South Dakota will expand Medicaid under the Affordable Care Act, after legislative leaders received early word the state’s request to petition a waiver will be denied. A letter sent by Governor Dennis Daugaard asks whether a waiver would be granted to South Dakota to expand up to 100 percent poverty level. But no official word has come yet from federal Health Secretary Kathleen Sebelius. Republicans and Democrats have differing views on the next step.
House Minority Leader Bernie Hunhoff says Medicaid expansion is the biggest public policy issue before them this session. It’s also going to be the biggest failure, he says, if nothing is done. Hunhoff says the state made a mistake not expanding health care coverage last year up to 138 percent poverty, and now there’s a standoff on how much to expand between the federal government and the state.
“Washington tells us, the law says you have to go the full boat to 138, it’s nonnegotiable it’s the law and they couldn’t negotiate that or waive that if they want to. Now, these are experts, these are the heads of the programs in Washington, D.C., what about 25-30 states have already expanded. Even if it wasn’t the law, they probably aren’t going to bend it for South Dakota because they’d have to go back and negotiate with the 25 or 30 other states,” Hunhoff says.
Hunhoff says if South Dakota was willing to expand to the full 138 percent, the state would be more likely to get a waiver. He says to expect an amendment to the general bill proposed to cover Medicaid expansion before the end of session.
Senate Majority Leader Tim Rave says he was part of the conference call with Medicaid officials who indicated South Dakota’s letter would be rejected. He says federal officials kept talking about being flexible, but were unwilling to bend to South Dakota’s request.
“Certainly, we would’ve been willing to, I think, have some discussions about options for those folks under 100 percent of poverty. Initially, our concept was to cover those folks, the working poor is who we’re looking at, really focusing on those adults that are just struggling to make it and obviously have no capacity to get health insurance,” Rave says.
Rave says it’s unlikely any sort of Medicaid expansion will happen this session, but there is possibility for a discussions or a special session this spring or summer if the federal government decides to compromise.