State Leaders Wait For Medicaid Plan

Feb 8, 2016

Outside the South Dakota Capitol.

Medicaid expansion is one of the major topics at the State Capitol this legislative session. Lawmakers are still waiting to hear details from the federal government before moving forward.


Governor Dennis Daugaard says he’s asked federal officials for yes or no answers about specific fact patterns.
“Dennis lives in Sioux Falls,” Daugaard says. “Dennis goes to Avera for primary care. He’s Native American. Avera has a contract with Indian Health Services that allows them to act as their agent. Will that be considered medical care through Indian Health Services? If so, 100% reimbursement. If not, 50% reimbursement.”
He says he’s waiting to hear back about reimbursement rates in a variety of scenarios. After officials receive answers, they will start doing the math.
“Do we save enough money, of the $67 million we spent last year, for bills where we weren’t fully reimbursed,” Daugaard says. “And if we do save enough money, either this year or next year, as we ramp up our state expense, as the state ramps down their support for the expansion population, will we have the $57 million in fiscal year 2021, so that any time between now and then our expenses at the state level, our savings at the state level, cover our increased costs.”
Democratic legislative leaders say they are completely in favor of expanding Medicaid.
Republicans say they are waiting to see the details of the plan.