Medicaid Expansion faces tough path forward in 2017

Medicaid expansion is the topic at hand in an Associated Press article this AM, regarding the possibility of it passing in the 2017 legislative session, now that plans for a special session of the state legislature have been canceled:

“I think the path for the governor’s office is potentially going to be tougher next session, but we’re continuing to march forward with the thought that that very well could be a topic for 2017,” said Ben Lee, state director at opposition group Americans for Prosperity-South Dakota.

Daugaard, who had floated the idea of a summer special session, decided against it after hearing from lawmakers who wanted more time to study the proposal and to wait until after the presidential election to consider it. The move was a blow to Democrats pushing for expansion, and Senate Minority Leader Billie Sutton said it would remain their top priority when lawmakers gather in 2017.

Their push would be helped if Democrats can gain some legislative seats in November to stave off a more conservative Senate, he said.

There are enough undecided and leaning legislators in both chambers to make expansion a “real possibility” in 2017, said Jennifer Stalley, a lobbyist for the Community HealthCare Association of the Dakotas, which is among many groups supporting expansion.

Read it here.

I think there’s far less support in the House than proponents think, and that’s going to be the easy chamber.  Expanding welfare rolls for able-bodied adults is not going to fly at all in the State Senate. 

The rank and file of the GOP recently noted (in part) in resolutions at the 2016 convention:

Whereas, the South Dakota Republican Party recognizes the crises in healthcare offered by the Veterans Administration and the Indian Health Service, and the failure of the federal government to keep its promises to those who receive these services.
Now, Therefore, be it resolved, the South Dakota Republican Party rejects efforts by the federal government to mandate or incentivize further government intervention in healthcare; and,

Be it further resolved, the South Dakota Republican Party is opposed to the expansion of the Patient Protection and Affordable Care Act, generally referred to as Obamacare; and, 

Be it further resolved, the South Dakota Republican Party urges the South Dakota state legislature, both house and senate, to reject and defeat efforts to expand Medicaid or adopt the Medicaid standards outlined in Obamacare.

Read that here

That’s probably a good hint that, at least among the Republican faithful, that dog is not going to hunt and Republicans remain largely unconvinced that it could be in their benefit.  And that’s not helped when the conventional wisdom is that there are no success stories in states who have moved forward with the expansion.

Coupled with Democrats’ likely legislative prospects this fall (slim to none) my crystal ball tells me that there is no visible path forward in the state legislature for Medicaid expansion in 2017, and you can arguably add 2018 to that prediction as well. 

23 thoughts on “Medicaid Expansion faces tough path forward in 2017

  1. Charlie Hoffman

    Any Republican who votes for Expanded Medicaid needs to be given a sign saying “I’m one of the 1 Percenters; I Love Obamacare!” And then change registration to Democrat.

    1. Anonymous

      You hear rumors that DD might run for congress if Kristi runs for governor. Would he campaign on expansion?

  2. Anne Beal

    I think the party platform where it says we believe education should include the use of original, historical documents, needs to start with the Republicans themselves reading the treaties I hear them referencing with regard to IHS. “We have to honor our treat obligations!”
    Ok, so exactly what are the treaty obligations?

    http://digital.library.okstate.edu/kappler/Vol2/treaties/sio0998.htm#mn9
    “Article 13: The United States shall furnish annually to the Indians the physician, teacher, carpenter, miller, engineer, farmer and blacksmiths, as herein contemplated….” Note here that only the blacksmiths are plural, but in article 9, there is only one blacksmith mentioned:

    “Article 9: at any time after ten years from the making of this treaty, the United States shall have the privilege of withdrawing the physician, farmer, blacksmith, carpenter, engineer and miller herein provided for, but in case of such withdrawal, an additional sum thereafter, of ten thousand dollars per annum, shall be devoted to the education of said Indians, and the Commissioner of Indian Affairs shall, upon careful inquiry into their condition, make such rules and regulations for the expenditure of said sum, as will best promote the educational and moral improvement of said tribes.”
    Article 4 describes the housing to be provided for all these experts, whose mission seems to be intended as educational, including one house for the single physician which is to cost no more than $3000. The single physician doesn’t get a fully staffed hospital or clinic, he gets a little house on the banks of the Missouri River.

    Now there are a whole lot of treaties archived at Oklahoma State at the site I linked to, but this is the Treaty with The Sioux of 1868 and it’s the only one I’ve found with any reference at all to medical services. There might be one in there someplace and I would love to read it if anybody can find it.

      1. Anne Beal

        Yes. One physician, in a $3000 house on the Missouri River. No hospital, no clinic, no nurses, lab techs, radiologists, pathologists, dentists or pharmacists. One physician, and a carpenter, miller, blacksmith and engineer. For ten years.
        Since blacksmiths have evolved into auto mechanics, perhaps the argument should be made that we have a treaty obligation to provide comprehensive auto repairs, too.

    1. Lee Schoenbeck

      Anne, if you go to your courthouse and talk a look at volume one of the code, many of the treaties are in with the historical documents.

  3. Anonymous

    Isn’t it too bad that the Governor who got elected saying he would not raise taxes and live within our means is so liberal that his Obamacare initiative is the rallying cry for democrats. He has more in common with democrats than republicans in this election. Disgusting!

    1. Anonymous

      The last two years have been mostly the 1st term priorities of Susan Wismer and Suzy Blake. They received 25% of the vote. Even Democrats abandoned her.

      Very strange.

  4. Anonymous

    The biggest obstacle in Pierre right now is Mark Mickelson. He hasn’t been very vocal but he must be smart enough to know that if he or the House supports medicaid expansion he doesn’t have a shot at winning a GOP Primary for Governor. I say his chance of winning is even smaller as of now than I expected.

  5. JimV

    The entire debate on Medicaid expansion is disingenuous and being pushed by special interests within the health systems. Let’s have a little more transparency in the debate. Who really is going to benefit from Medicaid expansion? My problem is who is at the table asking the tough questions about protections for the taxpayers of SD. It is quite apparent that the Governor has capitulated his responsibility and sided with the special interest. Mr. Mickelson has personal ties to the systems so we all know where he will fall in the debate.

    It is indeed a noble cause to find healthcare insurance coverage for all South Dakotans but not at the expense of out first priorities of education funding, public safety, and infrastructure. States that have tried by expanding Medicaid have busted their budget every time.

    The Federal Bureaucracies have a responsibility to find solutions for their failed programs in providing healthcare for IHS & the VA. We should demand they demonstrate competency in these programs before we embrace any more initiatives pushed by the Obama Administration.

    Here is a suggestion for delivering healthcare to the less fortunate in our state. How about we make the health systems tax-exempt if they use their financial gains (check the IRS 990 reports) to provide care for those who can’t afford insurance.

    1. Anonymous

      I like the last paragraph’s suggestion. Unfortunately, by limiting the power to tax, all the power-hungry politicians will lose some power and we can’t have that, can we?

  6. Springer

    Well, big surprise, Hillary was just found innocent of all charges by the FBI! Wow! Guess we can all breathe a sigh of relief now. In other words, the fix is in, Obama is campaigning with and for her, and based on his unbelievable ratings yet, the fix is in for her election too. So all we have to do is just wait for the election and we will have Hillary-care for all, and we won’t have to worry about expanding Medicaid anyway. I have about lost all faith in the honesty and integrity of any portion of this present government, and about the people’s ability to keep our form of government and freedoms.

    Benjamin Franklin said, when asked if we had a monarchy or a republic, replied, “A Republic, if you can keep it.” And I fear we have reached the tipping point and will not be able to. What a way to celebrate the day after the Fourth of July. We are on the verge of having a monarchy without the royal blood, and Chelsea is waiting in the wings to continue it.

    1. Anonymous

      “your” or “you’re”? I’m trying to make sense of what you are trying to convey by your oh-so-pithy post.

      It is obvious that the fix is in, and the Demoncrats will protect their own, even to the detriment of law and justice.

  7. Springer

    Anon, a good example of common core: your should be you are.

    We will see what we will see. Can you honestly say if ole Joe Blow had done what Hillary did, that she wouldn’t go to jail. Martha Stewart comes to mind; she was jailed for lying to investigators, and it is provable that Hillary did this. Sorry to be off topic.

    Back to Medicaid expansion – never, never, never! Make sure your legislators know this, and make sure those who you vote for this fall know this too.

    1. Anonymous

      Springer, a person who would say you are full of it and then not try to actually explain his/her argument isn’t going to worry themselves about using the English language correctly.

      I agree on Daugaard’s push for expansion-no way, Dennis!

      1. Anonymous

        Just like Obama, the GOP in South Dakota should start counting the days. I cannot wait until this liberal and his unemployable son-in-law cannot do any more damage.

  8. Charlie Hoffman

    Medicaid Expansion, Welfare Expansion, Food Stamp Expansion, Disability Expansion, Refugee Importation Expansion, all on the backs of the Shrinking Middle Class.
    If you are healthy but don’t want to work and want to watch from your couch the implosion of America from within—Vote for more of Barrack Hussein Obama—Hillary Rodham Clinton or Medicaid Expansion.

    1. Springer

      That’s the problem – probably at least half of her voters will vote for her simply because she is either a woman, promoted by the first Black president (and married to someone who people once called the “first Black” president), is a Democrat, and/or has bought her vote by promises of amnesty, free this and that, etc. And they won’t know any of the issues or care, they won’t understand the importance of the Supreme Court as a result of this election and won’t care, and will be pretty much ignorant on the history of the US etc. But hey, who cares about that when we can live for almost free with Hillary and we can all sing kumbaya together!