Gov Daugaard: No Medicaid Expansion this year.

72 thoughts on “Gov Daugaard: No Medicaid Expansion this year.

  1. Anonymous

    Thank you governor for protecting our citizens who are struggling under the Obama economy from further degradation of their condition.

    God bless…

  2. The Guy from Guernsey

    LOL, Dennis and Tonnis thought the feds were going to tell them to pound sand RE: the transfer from Medicaid onto IHS. Unfortunately, Obama, as well as his staff and cabinet outflank, outsmart and out-maneuver another of our Repub’s. Dennis and Tonnis take their place beside John Boehner, Mitch McConnell and John Thune as those outwitted by Obama.

    Good faith bargaining: If you extend an offer (and are public with terms of the offer) … you had better be prepared to deliver when the other side accepts your offer.

  3. Springer

    Stand strong against this expansion of Obamacare, legislators! Hopefully this time next year Obamacare and all its attendant disasters will be only a painful memory.

  4. JohnDoe

    Anyone else notice it’s a presidential election year? How much you wanna bet if Rubio were leading this site would be wall-to-wall coverage?

  5. Anonymous

    Cruz is a liar, Rubio embarrasses himself with his stand up act and Trump is unpredictable.

  6. Common Sense

    What I think most of you don’t realize is that we are paying for uninsured residents one way or another. If they do not have insurance, they use the ER. Do you think these ER bills get paid-NO. So guess where they make up that cost-with you and me by charging us $10 for an Advil or charging $10,000 a night to stay at the hospital. It is like retail stores that lose merchandise through theft, they pass the lost cost onto you by increasing the prices.
    So, why don’t we figure out how to provide healthcare for all so we can lower the cost of healthcare for everyone! Healthcare should not be a privilege.

    1. Cliff Hadley

      Common Sense…

      Uninsured people who go to the ER routinely for medical care continue to do so even after going on Medicaid. In fact, there’s evidence they make even more such visits. (See Oregon Health Study.) These are a subset of the same 40 percent of the population that doesn’t use traditional banks and prefers the payday lender when there’s too much month at the end of the money. It’s simply how they roll.

      In any event, hospitals already get reimbursed by Medicaid for uninsureds’ ER visits. Bottom line: Medical costs for you and me would not change by a nickel if everyone was insured.

      1. Anonymous

        –Medical costs for you and me would not change by a nickel if everyone was insured.

        Very accurate.

        Moreover, medical CARE is likely to deteriorate since doctors, nurses, & hospitals would be forced to care for more people in the same facilities in the same amount of time, making the care LESS available to all and of a lesser quality.

        WHERE’s the benefit for medicaid expansion? WHAT’S the common good?

      2. Anonymous

        –Uninsured people who go to the ER routinely for medical care continue to do so even after going on Medicaid.

        That’s what Massachusetts found as well.

    2. Anonymous

      CMS’ own figures show Medicaid recipients use hospital emergency rooms at twice the rate of people with real health insurance.
      Every state that has expanded Medicaid has seen more people than expected enrolling, many of them by dropping their real insurance. So the ratio of Medicaid to the privately insured keeps going up, putting additional stress on the providers. The providers need the privately insured to cover the money they lose on Medicaid enrollees. If they lose too much, they close up shop, and we will all have trouble getting health care. As people find they can’t get doctor’s appointments, more will give up waiting and head for the ER.
      Meanwhile, not only are the numbers of Medicaid enrolled higher than expected, they are spending more money than expected. CMS is optimistic that those costs will level off, but in the meantime that 10% that the state is supposed to cover is a lot more expensive than projected. So funding to cover the cost over-runs will have to be found elsewhere. It’s a mess.

  7. Springer

    We should provide health care to all???? This is exactly what is contributing to the gimme attitude in society today and why Sanders has the following he has. What about a person should figure out how to provide his/her own health care? Take a little personal responsibility. I understand some are unable to; fine, that is what Medicaid is for. But many or most on Medicaid treat this as a way of life and make no effort to improve their situations or take responsibility for their own expenses and welfare. I thought Obamacare was the promise to fix all this; at least that is what the great O and Pelosi and Reid spouted when ramming this through Congress. But it didn’t, and it hurt more people than it helped by less choice of doctor, less choice of insurance, higher premiums, higher deductibles. Health care is not a privilege, it is not a right, it is a personal responsibility.

      1. Anonymous

        Springer is a woman. Why do men always assume that only men post comments on blogs?

  8. crossgrain

    “But many or most on Medicaid treat this as a way of life and make no effort to improve their situations or take responsibility for their own expenses and welfare.”

    Census Bureau statistics don’t bear this out. A vast majority of people, something like 75%, who receive Medicaid assistance are off the dole within 4 years. Is there waste, fraud, and abuse? Certainly, but those occurrences are more rare than you think. As a safety net, Medicaid actually does a pretty good job. There’s no need to demonize those who’ve fallen on hard times, man, especially when so many DO improve their lives with a helping hand.

    1. Anonymous

      –Census Bureau statistics don’t bear this out.

      That’s not what Oregon found out when it experimented and studiesd expanding Medicaid.

      The study results:

      –researchers found that Medicaid had no statistically significant impact on physical health measures
      –ER visits of those with MC coverage increased by 40%
      — study found no statistically significant impact of Medicaid coverage on any of the four physical measures: depression, high blood pressure, elevated cholesterol, high glycated hemoglobin levels, long-term cardiovascular risks
      –Medicaid coverage increased annual medical spending by approximately $1,172 relative to spending in the control group
      (wiki)

      We’d be better off giving the $1172 to each person who qualified for MC (“the poor”) and have them spend it as they please, if the goals were to alleviate the financial costs and consequences (debt) of medical care.

      But, Medicaid is more about patting ourselves on the back for “caring” , than improving health of finances of the poor.

      There’s no need to canonize those who’ve fallen on hard times, man, especially when so many don’t improve their lives or health with Medicaid.

      1. Cliff Hadley

        Thanks, Anonymous at 11:47. All true. One other thing: Hospitals have been crying wolf on abused ER visits for 30 years, yet strangely, none of these institutions ever closes its doors. #hospitalslie.

        1. Anonymous

          I posted my comments before I went back and saw your post referring to the Oregon study.

          “common sense” in public policy is too often wrong when it comes to human behaviors.

          Crossgrain’s predictable emotional mantra about “don’t blame the innocent victim for his own ongoing poverty” is more meaningless and unsubstantiated blather.

          keep posting!

      2. crossgrain

        My comment was directed at the idea that welfare is “a way of life for most”, not at Oregon’s Medicaid health outcomes.

        Y’all feel free to debate the efficacy of Medicaid, but I was talking about demonizing the poor.

        1. Anonymous

          Who was “demonizing” the poor? NO ONE!

          Who was EXCUSING the poor and their destructive behaviors? Crossgrain.

          1. crossgrain

            I wasn’t excusing anyone, just pointing out that this whole notion of “welfare as a way of life” is overblown, and statistics do not bear out the notion in any way, shape, or form. It’s merely a device used by some to demonize the poor as being life-long leeches, when in fact, this is not remotely the case. “The Poor” are NOT preventing you from becoming rich. That’s the subtext here, and it’s simply a fabrication.

            1. Anonymous

              –The Poor” are NOT preventing you from becoming rich.

              Wonderful insight but NO ONE suggested any such thing.

              Nor are the rich preventing the poor from becoming “rich”.

              –That’s the subtext here, and it’s simply a
              fabrication.

              No, that’s not the subtext. You’re just imagining it as a strawman–so I guess YOU are the only one fabricating “subtexts”.

              1. Springer

                “Nor are the rich preventing the poor from becoming ‘rich’.” What a true statement! I think the SYSTEM (fed govt) is preventing a lot of people from not becoming rich but from achieving all that they could, if it wasn’t so easy to just accept the subsidies and freebies and quit trying to better themselves.

                I know people who choose to not earn over a certain amount of money, or finish college in a timely manner, or be a stay at home mom when they could work too and get benefits at a job, etc, because they then qualify for all kinds of govt benefits. And social services is many times encouraging this. And it’s WRONG!

        2. Anonymous

          –Y’all feel free to debate the efficacy of Medicaid

          Well, that was the topic you know.

          “Gov Daugaard: No Medicaid Expansion this year.”

          ‘Scuse us for discussing the actual topic.

          1. crossgrain

            Discuss it under a different (or new) comment then. My comment specifically addressed demonizing the poor as life-long takers, which a vast majority are decidedly NOT.

        3. Anonymous

          –My comment was directed at the idea that welfare is “a way of life for most”,

          Oregon’s and Massachusett’s experiences demonstrate that that “way of life” changes very little, even with Medicaid.

          Sorry, but those are the facts.

          1. crossgrain

            Please explain why 75% of those who receive Medicaid manage to get off it in under 5 years.

            1. Anonymous

              –A vast majority of people, something like 75%, who receive Medicaid assistance are off the dole within 4 years
              -=-Please explain why 75% of those who receive Medicaid manage to get off it in under 5 years.

              Please explain where your changing figures come from.

              1. crossgrain

                *sigh*

                Reading of the Census Bureau statistics… They go by months (48 in this case). It’s a simple typo on my part (5 instead of 4 (which is still factually correct)).

                1. Anonymous

                  –Please explain why 75% of those who receive Medicaid manage to get off it in under 5 years.

                  I suspect that you just made up the 75% figure, so that’s the only explanation right now.

                  I’ll give you one more chance to provide a basis for it (besides yourself of course).

                    1. Anonymous

                      Ah yes…I figured that source was what you were using.

                      The coup de grace folks:

                      1. The study that crossgrain cited was for years 2009-2012–4 years worth of information.

                      The study indicates that 35.3% of Medicaid participants from 2009-2012 were in the Medicaid program for 48 months. In other words, 35% of Medicaid recipients were in the program for the ENTIRE 4 YEARS OF THE STUDY!

                      Now, crossgrain claims that this 35% were in Medicaid for ONLY 48 months, but that’s not what the study states. In fact, for all we know, some portion of that 35% (but probably not all) are STILL in the Medicaid program many years later.

                      2. If one digs deeper into the underlying figures, we see that 72.5% of “poor people” (defined as 1.00 or below on income to poverty ratio) were using mean-s tested poverty programs for the entire 48 months of the 48 months study. Furthermore, 100% of “poor people” accessed those poverty programs at least 1 month in that 48 month period; 82.3% accessed those programs at least half of the 4 years covered by the study.

                      So, crossgrain is either ignoring his own source, or deliberately misstating its findings.

                      ––A vast majority of people, something like 75%, who receive Medicaid assistance are off the dole within 4 years

                      #3. The figure is 35.3% that were on Medicaid for 48 months. 49% (35.3% + 13.7%) were on Medicaid for at least half of those 48 months. There is NO FIGURE provided that indicates how many or what portion of that 35.3% got off of Medicaid after 48 months because the study ended after 48 months!

                      So, when Cliff claimed that “many or most” remained on these gov’t programs, he was 100% correct. 35% of those on Medicaid in a four year span were on Medicaid for ALL FOUR years! That’s endemic!

                    2. crossgrain

                      I thought the Census Bureau didn’t collect such figures?

                      Anyhoo, quick math fail on my part? 35% 1yr + 15% 2yr + ~15% 3yr = ~65%. My bad.

                      Still, 35%≠MOST

                      I’m sure “your readers” will be flooding me with sympathy cards because they have been waiting with baited breath for your killing stroke…

                      Guess I should just slink away from your esteemed wit, eh?

                    3. Anonymous

                      Other sources for Medicaid participation:

                      1999: 54% of eligible adults were enrolled in Medicaid
                      (1999 National Survey of Americas Families)

                      2010: 62% of eligible adults enrolled in Medicaid
                      Sommers & Epstein (2010)/ (CPS data)

                      If 75% were/are getting off of Medicaid after x number of years, why are Medicaid enrollments (both raw numbers and percentages) continuing to grow? NOT STATISTICALLY possible!

                      Now, it IS possible (and likely) that eligible Medicaid participants enrolled, then un-enroll periodically, but to claim as crossgrain did that they leave Medicaid for any significant length of time is not supported by the data.

                    4. Anonymous

                      –I thought the Census Bureau didn’t collect such figures?

                      They don’t–read their preface. They USE data collected by other agencies.

                      –Anyhoo, quick math fail on my part? 35% 1yr + 15% 2yr + ~15% 3yr = ~65%. My bad.

                      Huh?

                      35.3% were on Medicaid for the ENTIRE 4 years of the study–and by no means is there any data that they were on Medicaid for ONLY those 4 years.

                      Good so far but…

                      “Still, 35%≠MOST”

                      35% of what? For what?

                    5. Anonymous

                      –Guess I should just slink away from your esteemed wit, eh?

                      PLEASE stick around!

                      please!!!!!

                    6. crossgrain

                      I’d rather continue the conversation over a beer or 3. These narrow comments on this crap-formatted site get on my nerves…. and I refuse to use the gaggingly slow mobile site.

                    7. Anonymous

                      US Census Bureau:

                      “We obtain Medicaid participation records from the Centers for Medicare and Medicaid Services (CMS). ”

                      USCB does not collect Medicaid data.

                    8. Anonymous

                      As long as you pay 75% of the cost of beer, I’ll enroll in your medicaid program…for life.

              2. Anonymous

                The die, you moron! Most people on Medicaid are in nursing homes.
                They took the 25 or 30 year option on their pension plan, hit their 90s, run out of money, go on Medicaid, move into a nursing home, and then they die.
                CMS reports this phenomenon is winning

                  1. Anonymous

                    Well there you go again!

                    65+ The VAST majority of these folks are not on Medicaid because they’re on MEDICARE!

                    Children: Children are NOT eligible for Medicaid. Children are covered by CHIP, another federally-funded (largely) health program for poor & not-so-poor children.

                    So, if you use my sources provided above, somewhere around 60% of eligible adults are in the Medicaid program.

                    That would be MOST.

                  2. Anonymous

                    A day has passes and crossgrain has yet to explain how 75% became 65%.

                    Moroevr, he wildly misstaes the study he used!

                    65% of those in the study that crossgrain cited were on Medicaid at least one month in the 48 months of the study. Crossgrain simply lies when he claims that this means those 65% are no longer on Medicaid after 48 months! No, it means that 65% were on Medicaid at least one month in the 48 months of the study. For all we know, 65% or more continue to access Medicaid regularly, periodically, or continuously since the study ended in 2012.

                    Furthermore, 35% were on Medicaid for ALL of 48 months of the 48 month study. Obviously, this does not mean that those 35% left Medicaid after 48 months–for all we know, they are still on Medicaid.

                    Cliff’s point remains: whether Medicaid or other poverty programs, a significant percentage remain in one or more of those programs regularly.

                    Crossgrain’s cited study simply supports Cliff’s view.

    2. Anonymous

      –Census Bureau statistics don’t bear this out.

      The US Census bureau does not collect Medicaid participation data.

      Lie, er try again.

      1. crossgrain

        States collect the data for CMS. CMS passes it to the Census Bureau where it is aggregated to state and county levels by age and sex. The ‘data’ in question is largely useless until aggregation, so…. semantics? Perhaps? Either way, the Census Bureau publishes the data in a usable form for purposes of this discussion, hence: Census Bureau Statistics.

          1. crossgrain

            Explained in the other post. Still waiting for you to explain why a large majority of folks on Medicaid don’t stay on “as a way of life”.

            1. Anonymous

              No, you just asserted that it was 75% and claimed it came from the US Census Bureau.

              The US Census Bureau does not collect data on Medicaid recipients.

              So, where’d you get the 75% figure, and citing yourself does not count.

              –you to explain why a large majority of folks on Medicaid don’t stay on “as a way of life”.

              I made no such comment.

              1. crossgrain

                Ah, good. Then you agree that folks do not stay on Medicaid as a way of life.

                Other stuff is linked above.

                1. Anonymous

                  –Then you agree that folks do not stay on Medicaid as a way of life.

                  Ah yes, the fallacy of the false dichotomy.

                  Sorry pal.

  9. Troy Jones

    On an individual and static basis, one can make an argument to expand a program that alleviates hardship for the poor. However, taken collectively expansion of programs creates disincentives to long-term improvement in the plight of the poor and incentives to improve oneself.

    Let me describe two situations:

    1) Obamacare incentivizes businesses to stay below certain full-time employee thresholds and thus rely more heavily on part-time employees. This has two direct negative consequences: Employers don’t have incentive to provide skill training to part-time employees or otherwise invest in retention programs. This makes the poor more marginalized.

    2) When one looks at all the programs to elevate poverty, those at or near poverty lose benefits faster than their near-term income rises as they either work more hours or gain incremental raises. Thus, it makes short-term sense to not move up the economic chain or work more hours. This makes the poor more marginalized.

    Medicaid is a federal program among many federal programs designed to alleviate the condition of the poor. They need to be reformed on a federal level whereby they don’t unintentionally on the aggregate contribute to long-term marginalization of the poor.

    Thus, as meritorious as one might find Medicaid expansion on its own, expansion of a federal program in combination with the plethora of broken federal poverty programs as aggregated is policy which only makes the long-term condition of the poor worse. Solving a global problem requires global solutions and not incremental expansion.

    1. Cliff Hadley

      Good insights, Mr. Jones. The shame of it is, if Medicaid was a block grant program, it might actually be useful. As it is, the feds would never give up control. Sigh.

  10. Common Sense

    My main concern is how high health care is right now and insurance premiums. If you take a medium business of 1000 employees and let’s just say they all just take the employee benefit. No spouse or family, that equals $7,400,000 per year in insurance premiums. If they have a spouse=$14,600,000. Doesn’t this seem high? Why should costs be so high, just because we are talking about life we can jack the prices up? Can someone tell me how much insurances pay out a year and what their profit margins are?

  11. Springer

    Huh? Solving a global problem requires global solutions. Uh, no. Poverty in the US isn’t a global problem; it’s a US problem and is fed by the feel-good programs of the federal govt that in reality perpetuate the problem of the poor and their feelings of victimization. Maybe the problem starts in the schools where kids are not being taught personal responsibility anymore and are instead taught more that the govt will and should solve all of your problems; this is manifested by the young people who buy into Sanders’ speeches. Get back to teaching self-reliance, pride in doing a good job and taking care of yourself and your family, and teaching the basics that made this nation great.

    Your answer sounded like a one world govt type guy would say, and I didn’t think you were that.

  12. Troy Jones

    Springer,

    I didn’t mean global as in the globe. I meant global as in comprehensive. Sorry for the confusion. I agree with your comment about what we have perpetuates the problem more than it solves.

  13. Anonymous

    The feds cant require the states to Expand medicaid. That has never been a true or accurate statement in this discussion.

    Legislators, use this “savings” for teacher pay & property taxes WITHOUT raising taxes! Do NoT expand OBAMAcare this or next session.

    1. Cliff Hadley

      Unaware of any savings. Uncle Sugar was going to pay the entire tab for the expansion, at least initially. So it was being sold as revenue neutral, which was a crock.

  14. Anonymous

    Medicaid is a general welfare program that is unrelated to employers, so there’s no incentive or disincentive to maintain a “threshold” number of employees.

    Now, some employees may be eligible for Medicaid based on their compensation, but that is wholly unrelated to the number of employees. This is true under pre-Obama Medicaid or post- Medicaid “expansion”.

    Obamacare is something different, so such “insightful comments” are irrelevant, as usual. Under Obamacare (not Medicaid or expanded Medicaid), employers may come under its regulations depending on the number of employees.

    I think someone is confused about Medicare v. Medicaid.

    The topic here was Medicaid and its expansion–not Obamacare–and as such, the number of employees is irrelevant.

  15. Troy Jones

    Cliff,

    I think having it as a block program would be a significant improvement for a lot of reasons. One of which would be to allow states to use the money to purchase or subsidize health care premiums for the working poor who are pushed to part-time work because employers are avoiding the full-time employee threshold related to Obamacare or lower the cost of employer provided health care plans.

    The entire “social net” is becoming a tangled web of disincentives to moving up the economic ladder. Sometimes because of disincentives directly facing the working poor (loss of benefits from greater income) and sometimes because incentives for employers to not provide as many upward opportunities.

    1. Cliff Hadley

      Agree completely. My dismay is ever getting the feds to let the states take control and do it right.

  16. Anonymous

    Herseth Sandlin voted against Obamacare. SD governor Daugaard wants to expand it and taxes…and open up bathrooms to whoever has the urge.

    See a problem here?