Greetings! Hope summer is going well for all of you. Marcia and I have been at our lake cabin with grandkids. There is something special about teaching grandkids to fish. Jonathan, 7 yrs. old, caught his first northern, off the dock no less. I had him run to the shoreline and reel in from there. God only knows what could happen on the dock with our chocolate lab Mocha dancing around and then trying to lift the northern out of the water onto the dock! The fish wasn’t big to us (3 lbs.), but to a 7-year-old, it was huge. Great memories!
Let’s talk about ballot measures, specifically Medicaid Expansion, shall we? This is on the ballot on Nov. 8th as Constitutional Amendment D, Medicaid Expansion Initiative (2022). So what does Amendment D do?
Constitutional Amendment D would amend the state constitution to require the state to provide Medicaid benefits to all adults between 18 and 65 with income below 133% of the federal poverty level beginning July 1st, 2023. Because the Affordable Care Act (Obama Care) includes a 5% income disregard, this measure would effectively expand Medicaid to those incomes below 138% of the federal poverty level.
How much is that you ask? It is $17,774 for an individual and $36,570 for a family of 4 in calendar year 2021.
To date 38 states have done this (expanded Medicaid). South Dakota is one of the 12 states that have not.
Who do you think supports Amendment D? Any guesses? It is sponsored by a group called SD Decide Healthcare and is sponsored by SD State Medical Association, SD Nurses Association, SD Education Association, American Lung Association, American Heart Association, American Cancer Society, SD AARP and many, many others. Looking at what organizations have donated money to Amendment D, thus far, are the following:
- Avera Health $250,000
- Farmers’ Union $250,000
- Sanford Health $250,000
- SDAHO Enterprises $250,000
- Monument Health, Inc. $100,000
and others with lesser amounts, so far. It will be interesting to see how much those donations increase as we get closer to the General Election on Nov. 8th. South Dakota Healthcare has $1,572,585 in contributions. The cost of Amendment D for South Dakota is figured at around $80 million. Federal government has indicated they could fund South Dakota initially.
So, why is this not a good idea? Thought you’d never ask! First off, the Federal government is approaching $30 trillion in debt with no end in sight. We keep taking all this “free” federal money, but what happens when and if the federal government goes bankrupt? It is almost unthinkable what would happen. I say it is time to draw a line in the sand and say, “enough is enough.”
Another major reason not to do this is that we are covering the able-bodied workforce. Actually, we would be making winners and losers; those who make more than $17,774 and those who make less. It is the same for a family of four who make more than $36,570 and those who make less. This concept penalizes the able-bodied workforce who have worked hard to get a career that pays above this standard and those who have a job with health benefits. Is that what we want to do?
Another point that needs to be made is that in South Dakota there are more jobs than workers available. Medicaid Expansion is only going to worsen our worker shortage.
Please vote NO on Constitutional Amendment D.
To the citizens of South Dakota and to the men and women in uniform, in honor of all who served, in respectful memory of all who fell, and in great appreciation to those who serve today, Thank You, for giving me the opportunity to represent you.
Tim R. Goodwin, District 30 Representative
[email protected]
An even better reason for defeating this measure is that Medicaid is fraught with fraud, abuse and mismanagement…to the tune od $80-100 billion dollars. Let’s force them to resolve those issues before taxing taxpayers more.
An even better reason for defeating this measure is that Medicaid is fraught with fraud, abuse and mismanagement…to the tune of $80-100 billion dollars a year. Let’s force them to resolve those issues before taxing taxpayers more.
To those who say the federal government will pick up most of the tab, that is only for a specified time. They will cover less and less every year, and South Dakota taxpayers will pick up more and more of the cost. Also, look at others states who have adopted medicaid expansion, and the cost ends up very much higher than promised. And once people get used to “free” health care, they will feel entitled and it will be impossible to end.
You got that right!
Save the taxpayers from the expense? Did you forget about the state law mandated obligation for Counties to provide poor relief? Typical run around. Don’t want to pay at the state level, but let’s stick it to under funded local government.
Yep, keep sticking it to health care providers like hospitals to provide care to the medically needy. They’ll just pass it on to the rest of us. You Republikans are all about “right to life,” but not so much about meaningful support of families.
As usual your position is that of NOT helping the working poor. Dont you ever get tired of keeping working Men and Women down?
I get tired of paying for the “working” poor.
This is one of the best articles I have seen here. Goodwin did a great job. Too bad he won’t be down there for the next 2 years.
I am for Amendment D. It is estimated that an additional 40,000 Souuth Dakotans would be covered under this amendment. I can’t argue with the numbers.
You are for Amendment D, as long as others are paying for it.
We already are paying for when they use the emergency room as the clinic. Counties pick up some of the tab and the rest is pushed onto those of us who can pay. Ammendment d will allow them to have cheaper access to prevent more serious problems and the pool paying for it is spread out more. Getting people insurance will always be cheaper unless we can dent them care, which we can’t. So much for you pro lifers.
*deny
Anonymous at 7:21 your statement is incorrect.
CMS published some horrific statistics about who is using the Emergency Departments and who isn’t.
It’s people on Medicaid using hospital ERs at 2-3 times the rates of the uninsured and privately insured.
get it? It’s not uninsured people using the ERs inappropriately, It’s not the privately insured either. It’s people on Medicaid. People on Medicaid will go to hospital ERs because the tylenol and cough syrup are free..While everybody else goes to the drug store to buy their OTC drugs, Medicaid enrollees go to the hospital ER. Because it’s free..
oh, and they need to get their temperature checked, because a thermometer costs $10 at the drug store, too.
I have worked in hospital ERs; I’ve seen this. If only they knew how many of them leave diagnosed with “TSTLS” (Too-Stupid-To-Live-Syndrome) or “GOMER”
(Get Out of My Emergency Room AKA Grand Old Man of the Emergency Room)
And we pay for this nonsense, with our taxes, and our cost-shifted medical bills.
The whole idea that enrolling more people in Medicaid will relieve congestion in hospital ERs is a delusion. It will make the problem worse..
If it is such a good idea, it should be passed by the legislature. When the libs can’t convince the legislature that something is a good idea, they head to a constitutional amendment. This issue does not belong in our constitution.
Amen!
So, you don’t like democracy and letting the people actually decide? Maybe if the Legislature actually listened to the people the people wouldn’t need to bypass the Legislature.
Bingo. Amendment A passed (and it wasn’t just “libs” voting for it) so it’s clear the desire of the people is there. The Senate decided they knew better than us and didn’t pass the legalization bill. Now the people will tell them what we think, again.
If you don’t like it this way you could always move to Minnesota where they don’t have citizen ballot initiatives.
And I’m voting Yes on D.
Then do an initiated measure. It doesn’t belong as a change to our constitution.
Who are you to decide that? Let the people decide and I don’t think you are going to like the result. The more our elected officials push back, the more the people go against them. if there is one thing I know about South Dakotans, they don’t like being told what to do and they will vote for/against something out of principle to counter what they are being told. History has proven that.
Rec Marijuana on the ballot this year is going to prove that theory correct again. I bet it gets between 60-70% approval. What are you guys going to do when a lot of Republicans vote for it? Are you going to start calling this the pot blog as well since it will represent a good chunk of those people?
Tried that with IM22 and the legislature overturned it. Keep messing with things and we’ll make it harder for them. They made that bed, not voters.
I’m a hard no on this one. Especially when the health organizations in this state each donated $250k to make it happen. Sure is odd they have all that money to donate but their staff makes jack squat, except the c-suite.
This was a very poor stance on the issue, was it supposed to convince anyone to oppose? Who do you think is funding all the negative publicity on pipelines and gas prices, should I oppose those as well?
It is hard to be a christian and in the GOP, you have money behind handed out in all directions to take a position, but try to have some principles and values. Emergency room healthcare is not healthcare, furthermore, it just increases the cost of healthcare for those of us that actually pay for it. Avoiding this problem is not solving the issue, either treat it like a business as you imply, and don’t force healthcare providers to give their services for free (repeal the Reagan era EO), let people die on the curb, or find a solution. We all know we need to reduce the cost of healthcare, and this is one solution. If you think it costs too much money, then let people die, but don’t be pulling the “pro life” line out anymore.
I’ve said this from the beginning. As long as we are forced to pay and not deny care, the best option is to get these people on insurance so they have traditional access and we should see lower costs to provide care for them in the long term because serious conditions are not left to get worse and they aren’t forced to use the ER. I think along with that, we should have requirement that they visit the doctor on a regular schedule for physicals to insure we aren’t letting small issues become big issues. Risk pools will always be cheaper for the individual and the group as a whole.
Tony, It is a fallacy that the uninsured are using the ERs.
No, it’s not them.
It’s not the privately insured either.
CMS published the stats: Medicaid enrollees use hospital ERs at 2-3X the rate of the uninsured and the privately insured.
More people on Medicaid means more people going to the hospital ER for their care.
I knew one welfare mama who always took her kids, no matter the illness or injury or time of day, to the ER. When I asked why she didn’t make a clinic appointment, she responded “What clinic?”
The only care the uninsured can receive it through the ER. Clinics won’t schedule appointments for them. Times have changed Anne and most uninsured use the ER as their clinic. “What clinic” Sounds like an education issue that they need to be made aware of and its not surprising they are lacking in that department. I’d require clinic appts to be automatically scheduled for all medicaid recipients for every 6 months to stay on top of issues or identify problems before they become expensive. Going 5 years between doctor visits is unacceptable.
A fallacy? Whatever Fox News host told you this, they are wrong. Look at your county clerk docket, I guarantee you it is filled with medical debt collections. The cases that make it to court are about 30% of the actual claims. Call any of your local debt collectors, ask who their #1 client is, it is always medical. Ask the Avera, Sanford, or Monument health lobbyists. Show me your evidence of this so called “fallacy”.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564052/
not Fox News.
I’ll make it quick: People on Medicaid go to hospital EDs 7X more often than privately insured people for non-severe problems and 4X more often for conditions resulting in hospitalization.
Efforts to sugar coat the problem with excuses for this behavior are pointless. The only way to stop it is with the same copays the privately insured have to pay.
This is an existential tipping point. Take a hard hard look at every state that’s in a debt hole they can’t get out of, and how they got there, as you consider the lasting effects of this vote. Thanks Rep Goodwin for your top notch service to SD.
How was it that somebody came up with the 42,500 people will go onto Medicaid?
Where did that 42,500 come from?
I have seen estimates that we have about 80,000 people currently uninsured.
Then there are the tribal health enrollees. All 68,000 of them?https://dss.sd.gov/docs/medicaid/1115waiver/Improving_American_Indian_Health_in_SD_App.pdf
Read this. All about enrolling tribal members, who are already covered by IHS, in Medicaid. Shift the cost to the state?
We have come a long way from the health care promised in the Ft Laramie treaty of one physician living in a $3000 house down by the river. Mission creep on steroids.
Anyway, I think the estimate that Medicaid expansion will enroll only 42,500 people is huge miscalculation.
https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/199046/ED-report-to-Congress.pdf
Here is another good long read which shows how the problem of inappropriate hospital ED visits got worse in states which expanded Medicaid. Of course more people on Medicaid turned into more people using the hospital EDs who were on Medicaid, as the number of people who were uninsured or privately insured declined.
But this study here shows that Medicaid patients visit hospital EDs at 4X the rate of the privately insured, and 7X the rate for low-severity (think: inappropriate use) incidents.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564052/