Yesterday, the New York Times picked South Dakota in trying to illustrate a gulf between our congressional delegation and the Governor on the implementation of Medicaid expansion as a provision of Obamacare:
John Thune of South Dakota, the No. 3 Republican in the Senate, voted earlier this month to repeal major provisions of the Affordable Care Act and to end its expansion of Medicaid, arguing that the health law was “unpopular and unaffordable.”
A week later, his state’s Republican governor, Dennis Daugaard, announced that he wanted to make 55,000 additional South Dakota residents eligible for Medicaid under the law.
“I know many South Dakotans are skeptical about expanding Medicaid, and I share some of those sentiments,” Mr. Daugaard said. “It bothers me that some people who can work will become more dependent on government.”
“But,” Mr. Daugaard said, “we also have to remember those who would benefit, such as the single mother of three who simply cannot work enough hours to exceed the poverty line for her family.”
In state after state, a gulf is opening between Republican governors willing to expand Medicaid coverage through the Affordable Care Act and Republican members of Congress convinced the law is collapsing and determined to help it fail. In recent months, insurers have increased premiums and deductibles for many policies sold online, and a dozen nonprofit insurance co-ops are shutting down, forcing consumers to seek other coverage.
Is there really a gulf between Daugaard and Thune on Medicaid expansion? I don’t think so. Both Daugaard and Thune have been steadfast on most provisions of Obamacare being “unpopular and unaffordable.” But focusing on the provision to expand Medicaid as justification for a rift doesn’t seem to work to say there is.
South Dakota is a bit of an outlier in this argument, as Governor Daugaard has only vowed to expand the program if the money could be found without raising fees or taxes. And he’s negotiating with the Federal Government to cover health care expenses for Native Americans through IHS, instead of dumping them off as an expense of State Government as a strict condition of even considering the expansion in the first place.
That doesn’t sound as if we are absolutely going to do it. It sounds more like “we may, but…”
State Democrats in the state have been falling over themselves to call this a victory for their agenda... but they should not start clucking so quickly.
When Daugaard says “It bothers me that some people who can work will become more dependent on government,” Dems should consider that there are people in the process who are not just bothered, but dead set against any expansion of welfare. Couple that with the fact that the expansion proposal could be derailed at any point by any number of things, Medicaid expansion in the state could come to a careening halt.
Also consider the aforementioned fact that if the money can’t be found within the confines of the budget, the deal is off. And don’t forget, the federal government has yet to signal that they’d even consider signing off on the IHS proposal.
Despite what the New York times is proclaiming, Daugaard is not painting himself into a corner to accept expansion unconditionally. In fact, it’s the very opposite. it’s very conditional, and it may not happen, except to solve another problem our state has in the federal government not paying medical expenses for a group of people they should be covering.
If anything, it may be using the carrot of a program the Federal Government wants to get them to reach completion of their promise of another.
If the Obama Administration does the right thing and reimburses the State of South Dakota for the expenses incurred by Native Americans who seek medical attention from providers who are not on the reservation, why do we need to jump to the conclusion that that money needs to be spent expanding Medicaid? The conservative thing to do with that money would be to return it to the taxpayers in the form of a tax rebate, put the money in the reserves, use the money to pay state debts, and/or use the money to prevent proposed tax increases, such as those for teacher pay, from being necessary. So-called found money does not need to be spent! That is the way that liberals think!
Put the money in reserve are you on this Earth.The reserves this state has is astronomical they could take that and serve the teachers.The state is being reimburseed by the Government.Instead of in the past those not served can now bwith out any charge tot he state.
whats not, your post is so poorly written that it did not make sense even after I read it three times. If you are a product of the SD schools, your teachers should be fired instead of given a raise. So too should the administrators who approved your graduation from elementary school, middle school, and high school. If you reread my original post, however, you should notice that I argued that the money gained from the federal reimbursements in question could be used for increasing teacher pay.
Lead story hour 3, Limbaugh.
This post is one rationalization stacked on top of many rationalizations.
Thune and Daugaard are on the same ground: pretend you are against Obamacare until there’s something in it for you or your cronies.
I suppose it would be too much to ask that the people who should be covered by the IHS could utilize the services of the VA and let those two agencies fight over which pocket the money should come from.
Only if they meet the standards of poverty at the Va or disability.
What no usual comment about not being able to tie basketball shoes and show up for a photo op?
Partially right, Governor. You mean many who ALREADY work will be eligible for Medicaid. With some of the lowest wages on USA what do you expect?
Please explain.
South Dakota was center stage on National Radio today; and the Conservative Think Tank thinks we are horribly on the wrong end of good public policy for even thinking of Expanding Obamacare’s Medicaid program in a normally Conservative State.
But what the heck; lets just keep playing by Washington’s Rules and go down the River with them.
Charlie: There is no doubt in my mind you’d vote to expand Medicaid without a whimper. You’d willingly go along with Obama and Daugaard’s agenda.
The idea that Daugaard and Obama are one and the same is as silly of an idea as saying Charlie Hoffman is a rubber stamp for eithers agenda.
Ok Gov go to a basketball game where Photo op is and get your picture taken holding a basketball.Spend more time running around to and take a camera..
Anon 7:08 there is no doubt you are seeing everything through foggy lenses. Stimulus was a different animal with no crying at G-Bill voting time.
You wish it was a “gulf,” rather they are existing in parallel, yet, uniquely different universes on the issue.
Come to think of it, Medicaid is a lot like the IHS: both promise to pay for the medical care their enrollees receive, and neither pay in full, if at all. Providers are left with no recourse but to cost-shift the difference, which is what they are doing anyway. The cost shift is paid by the privately insured who are also the taxpayers, the same people. Advocates of Medicaid expansion like to promote the idea that it will reduce cost-shifting but actually, it doesn’t; if it did, the providers would reduce their rates. When you hear that line of BS from a healthcare provider, ask him “so if we expand Medicaid, are you going to reduce your rates? By 5%? 10%?” Haha
Then they’ll tell you that putting more people on Medicaid will reduce the use of high-priced emergency services. It doesn’t do that either, as Medicaid enrollees actually use emergency rooms twice as much as everybody else. They have nowhere else to go.
So the insured taxpayers will pay for the increase in emergency room visits twice:
Their taxes will pay for whatever portion of the visits are reimbursed by Medicaid, and the overpriced charges on their own medical bills will pay for whatever Medicaid doesn’t pay. This plan just ensures that it will cost a lot more, by increasing the use of high-priced emergency room services.
I would say yes and it’s quite wide and deep. Thune would be primaried if he came out and supported Medicaid expansion. He is smart enough to know that he is up for reelection and is a member of the Republican Party. Daugaard knows he has more flexibility because he is termlimited and will not be running for reelection.
This is a very interesting scenario. I welcome differences of opinion in a political party because it is nice not to have group think.