Improving Our Medicaid Program
A column by Gov. Dennis Daugaard:
South Dakotans believe in self-reliance. The pioneers who settled this state over a century ago, as well as the natives who preceded them, understood the need for self-reliance. In fact, they knew no other way. Those who came to Dakota sought freedom and a fresh start. They understood, though, that freedom requires responsibility, because they could only survive by taking care of themselves.
As a second key value, South Dakotans believe in hard work. It is simply a part of our culture. When we promote South Dakota as a good place to do business, we promote the work ethic of our people. Those who do business in South Dakota and elsewhere will attest to the fact that South Dakotans know how to work. There’s also a sense of pride that comes with having a job to do and being able to provide for your family.
The Trump Administration recently indicated it is willing to consider state work requirements for Medicaid participants. The federal government just approved a work requirement as part of Kentucky’s Medicaid program, and I have asked the Department of Social Services to pursue a work requirement for able-bodied adult South Dakotans enrolled in Medicaid here.
This would not apply to every South Dakotan on Medicaid. Our Medicaid program today covers roughly 82,000 children; 23,000 aged, blind or disabled persons; 1,000 pregnant women; and 13,000 very low-income parents. The work requirement would apply only to very low-income parents who aren’t already working or caring for a young child. This would place the work requirement on approximately 4,500 individuals in South Dakota.
By July 1, South Dakota will submit a proposal to seek approval for the work requirement, starting with a two-year pilot. If approved, we will begin with 1,300 Medicaid recipients who reside in Minnehaha and Pennington counties – where there is the greatest availability of employment and training resources. Pending approval, we will begin a voluntary program in these counties in July.
The Department of Labor and Regulation will enroll participants automatically for individualized employment and training services to help them find jobs. For those who earn enough to transition off of Medicaid, we will provide assistance – such as child care subsidies – to ensure their long-term success.
All work has dignity, and work is an important part of personal fulfillment. By making this adjustment to our Medicaid program, we will continue to help persons in need, while helping find jobs for those able to work, and also find that sense of pride and accomplishment which accompanies work.
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Medicaid has historically stiffed physicians for reimbursements that are well under costs. Where’s the dignity in that, governor?
P.S. As I’ve mentioned at this site before, my father, a small-town doc in Nebraska, never bothered with Medicaid paperwork. “I already donated my time treating patients I’ll never see again,” he’d say. “The feds don’t even pay enough to cover my time filling out their stupid forms.”