County officials expect to see a 'significant decrease' in costs of covering medical expenses for low-income individuals.
That’s due to voters passing Medicaid expansion in the last election.
If someone receiving hospital care cannot pay, they can apply for financial assistance from the county they live in. For several counties, hospital bills consumed a large part of their budget.
Ray Koens, the president of the South Dakota Association of County Welfare Officials, said when the Affordable Care Act rolled out in 2014 Medicaid coverage lessened the health care assistance burden.
“That made a difference for us. That covered a lot of people we otherwise would have seen for indigent health care,” Koens said.
Koens also works for Minnehaha County.
Statewide, the total cost to counties for medical services has gone down, declining from $2.6 billion in 2011 down to $860 million in 2019. That’s a 67 percent decrease in cost.
The number of claims has also dropped. Koens says Minnehaha County used to process 15 people a day. He says his office is seeing anywhere from five to 10 percent of that, now.
Koens expects the number to drop even further. He anticipates Medicaid expansion covering most uninsured patients on the county medical indigent rolls.
“But even so, there will be some folks that fall between the cracks that don’t qualify for Medicaid, don’t qualify for ACA, don’t have employer insurance, that sort of thing will still come to our office,” Koens said. “But it will be far less than number’s we’ve seen historically.”
Mandated expenses, like jail medical costs, increased during that same time. Koens said it’s unclear how Medicaid expansion will affect that cost.
Koen’s presentation is part of a legislative study looking at the cost’s counties incur in providing other mandated services—like roads and elections. Counties are restricted in their ability to raise funds but are facing increased costs for those services.
Medicaid expansion went into effect earlier this year. One Republican lawmaker points out those health care costs will shift from the counties to the state and federal government.
