Providing Obamacare Relief for South Dakotans
By U.S. Sen. Mike Rounds (R-S.D.)

Obamacare premiums rose 20 percent for South Dakotans this year, and I continue to hear stories of fewer health care options and out-of-control health care costs as a result of the ill-advised Affordable Care Act. While repealing Obamacare and replacing it with a consumer-driven, truly affordable system remains a top priority for me, we continue to take meaningful steps to provide Americans relief from this law.

The Tax Cuts and Jobs Act helped relieve Americans from Obamacare, by including provisions to delay the Medical Device Tax and the Cadillac Tax for two years and by delaying the excise tax on health insurance plans for one year. Importantly, this legislation also repealed Obamacare’s individual mandate, so that nobody will be forced to pay a tax penalty if they don’t want to purchase health care coverage that they don’t want or need. The individual mandate was an unpopular tax in an unpopular law that disproportionately hurt low-income families. We’re glad to see it go away. We were also able to successfully repeal Obamacare’s Independent Payment Advisory Board, which is a special panel of unelected bureaucrats tasked with finding savings in Medicare by rationing health services for seniors.

The Trump administration has also taken steps to give states more flexibility in administering federal mandatory spending programs. Most recently, the Centers for Medicare and Medicaid Services (CMS) announced it will give states more flexibility regarding work requirements for certain Medicaid beneficiaries. This will allow governors and state government leaders to shape state Medicaid policies that work best for their state rather than following rules issued by Washington bureaucrats. Already, nine states have applied for work requirement waivers to implement these new flexibilities and two waivers have been approved, including South Dakota’s.

President Lyndon B. Johnson created Medicaid in 1965 as part of his War on Poverty. The intent of the program was to provide health services for low-income children, seniors in need, individuals with disabilities and pregnant mothers. It was designed to be a pathway out of poverty.

As Americans, we take care of the most vulnerable in our society—the very young, the very old and those who cannot take care of themselves. The Affordable Care Act opened up Medicaid to include healthy, able-bodied, working-age men and women, which has added to the high cost of the program. In 2015, an estimated 70 million people were enrolled in Medicaid. That is 21 percent of our entire population!

Medicaid and other mandatory spending programs like Medicare and Social Security are on an unsustainable path. In the long-term, Congress needs to reform the federal budget process so that it can exercise greater control over the sustainability of mandatory spending. In the short-term, giving states the flexibility to manage Medicaid in new, innovative ways will help make Medicaid more manageable.

These are important steps toward our goal of eliminating the unpopular aspects of Obamacare, but the fact remains that premiums are still too high, insurance companies are leaving the marketplace and millions of Americans have been forced off plans they liked. I will continue to work with my colleagues to relieve hardworking families from Obamacare’s perils as we seek to make health care truly affordable and accessible for all Americans.

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Know Your Heart
By Rep. Kristi Noem

Never underestimate the power of your story. Earlier this year, Aletha Maki visited our Washington, D.C., office from Rapid City. Her granddaughter had been diagnosed with high cholesterol at age two, a condition brought on, the family learned, by a genetic disorder called familial hypercholesterolemia (or FH). Once diagnosed, the disease is manageable. But 90 percent of those with FH are unaware, and therefore, go untreated.

According to the FH Foundation, “Left untreated, men are at a 50% risk of a fatal or non-fatal coronary event by age 50, and women are at a 30% risk by age 60.” Aletha’s family each got tested after her granddaughter’s diagnosis. Her daughter, son-in-law, and grandson were also found to have the condition. With as many as 1,700 South Dakotan likely to have the disease, Aletha’s “ask” of our office was to help spread awareness. February is recognized as American Heart Month, so it seemed like an appropriate time to help raise awareness about FH and other heart conditions.

Cardiovascular disease can be the result of genetics, lifestyle or a combination of the two. Understanding the root of your condition may help your doctor hone in on a treatment. Additionally, as is the case with FH, an early diagnosis of a genetic condition could help reduce your risk of a cardiovascular event later in life. So, don’t wait until you have a problem to get to know your heart. Schedule a trip to your doctor’s office and ask them about heart health. Use your doctor as a resource to help set goals.  Then, listen to their advice.  If you need medication – for high blood pressure, cholesterol, or something else – take it as prescribed.  If you’re having trouble doing so, you can talk to your doctor about that too.

In many cases, lifestyle changes might help too. Even 15 minutes of walking a few times a week can make a difference.  Why don’t you try it for February and see if you can make it a habit?  While you’re at it, the Center for Disease Control and Prevention recommends kicking some other unhealthy habits too, like smoking.

Simple changes on your plate can make a big difference too. The American Heart Association posts great heart-healthy recipes at recipes.heart.org, if you’re looking for something new to cook up.

Every year, 610,000 people lose their life to heart disease, an astounding number when you consider that’s nearly equivalent to South Dakota’s population. The number is certainly troubling, but as time goes on, research teaches us about more ways in which we can manage this disease. To take advantage of that information, however, you must first get to know your heart. Take inspiration from Aletha’s family. Get a check-up. Learn what can be done to minimize any risk factors you have. And make a change today.

The Complex Issue Of Addiction
A column by Gov. Dennis Daugaard:

As a state, we grapple with many issues.  Some are very complex, with no easy fix or single solution.  These may require sustained effort over long periods, through different administrations and legislatures and generations of South Dakotans. Drug abuse is one such issue.

We continue to wrestle with methamphetamine use in our state. On the prevention front, the Department of Social Services has funded more than 245 presentations, to thousands in communities and schools, urging against methamphetamine use.  The Attorney General’s office has also undertaken a preventive education campaign. This month Prevention Resource Centers will complete a meth prevention toolkit for communities.

For the most part, we are seeing less meth manufactured in home-grown laboratories. It is more often manufactured on a larger scale and trafficked into the Midwest. The drug interdiction task force, made up of Division of Criminal Investigation agents and Highway Patrol officers, has been hard at work over the last year to stop meth from coming into our state and we need to continue to do more to choke off these distribution channels.

For those who are severely addicted, the Department of Social Services is working to expand and increase access to treatment, ensuring treatment is evidence-based and that providers are equipped and trained to provide intensive treatment models.

We’ve recently seen some hopeful results from our treatment programs. In the last year, more than 2,000 offenders have received treatment for substance abuse under the Public Safety Improvement Act.  In 2017 over 69 percent of individuals entering treatment for substance abuse completed successfully, 25 percent higher than the national average. Ninety-eight percent of those that completed treatment in 2017 reported an ability to control alcohol, 94 percent reported the ability to control drug use, and over 85 percent reported employment at discharge.

We’re seeing a promising trend in smoking as well. The smoking rate among young adults in South Dakota went from 34 percent in 2011 to 13 percent in 2017. High school smoking rates went from 23 percent to 10 percent in that same period, putting us below the national average for the first time.

We can celebrate that we are turning the tide on smoking and seeing success among those who seek drug treatment. These facts make me hopeful that South Dakota can meet the addiction challenges ahead.

We cannot mandate away addiction; no legislative fix will completely solve the meth problem. Some answers simply extend beyond government’s capabilities.  But we must do all we can, and we need all hands on deck. Private organizations, law enforcement, communities and individuals all have a role to play. Progress may be incremental but it will come so long as South Dakotans are persistent.

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WOW. Literally on the heels of Dakota Posts’ newest.. well, post, I had a reader send me this e-mail that’s making the rounds.  If you recall the other day, former Citibank general counsel Dave Zimbeck had a fairly critical letter to the editor regarding Senator Stace Nelson:

For instance, the latter offer of an opportunity to engage in a great debate over a state nosh, the legislation’s sponsor, Sen. Stace Nelson, R-Fulton, provides fellow legislators a welcome reprieve from his incessant “man-splaining” of how the Second Amendment to the U.S. Constitution is controlling over all others; not to mention routine temper tantrums, while regularly purveying conspiracy theories, with little if any suggestion of substantiation. He, the champion of “food fights” of another form. Even the most casual observer of politics in S.D., can take one look at a rather corpulent Senator Nelson and recognize that he would not recognize a “nosh” if it hit him in the head. The notion of something resembling a snack must be an anathema to a person of his girth, yet he finds the need to spend even the smallest amount of time debating the merits with this latest, albeit less destructive, food fight.

and…

Speaker Mickelson and other leaders, need to gain control over the nonsense before most of us can be convinced that S.D. should do anything but go to a biennial legislative session.

Read that here.  That was that.. until today, when this e-mail started making the rounds:

From: Dave Zimbeck [redacted]
Sent: Friday, February 9, 2018 11:29 AM
To: [email protected]
Subject: Your investigation

Sen. Nelson,

I recently learned that you are conducting an investigation of my voting records. Glad to know that you are still able to put to use your NCIS investigative skills.  By all means, proceed.

Of course, you can always just email me if you have any questions of a private citizen who is critical of your best use of time during the legislative session. I sincerely hope that you have fun.

Bon appetite!
DZ

Wow, again. Are we reading that a State Legislator is allegedly  “conducting an investigation” of the voting records of a private citizen who wrote a letter to the editor critical of him?  I can’t say I’ve ever heard of such a thing.   And I’ll repeat it because I’m a bit incredulous – a State Legislator is allegedly “conducting an investigation” of the voting records of a private citizen who wrote a letter to the editor critical of him?

Amazing.  And it gets better…  Because Senator Nelson responded, and CONFIRMED he was investigating him:

On Feb 9, 2018 11:59 AM, “Stace Nelson” <[email protected]> wrote:

Mr. Zimbeck,

Not surprising, just confirming another loud mouth Democrat masquerading as a Republican. You clearly have no clue about the process or the duties involved in Pierre and think the job entails simply being a tax and send RINO like the rest of your kind. You don’t like all the work I do for my constituents? Tough! suck it up buttercup. Or? Feel free to come up and poke me in the chest and run your suck like a man instead of some whiny malcontent. Now scurry off, the big mean conservative Bull elephant has better things to do.

SVN
Sent from my iPad

So, when pressed about his investigation of Zimbeck, Nelson admits he was “just confirming” his suspicions? Ugh. How many times has anyone ever heard of a sitting State Legislator “investigating” someone who wrote a letter to the editor disagreeing with his frivolous legislation?

As far as I’ve heard, NONE. NOT ONE EVER. NO ONE DOES THIS. 

But by the same token, no one else refers to themselves as a “conservative Bull elephant” (as is Nelson’s tendency).  Did he do so because calling one’s self a bull elephant will impress someone who was Citibank’s General Counsel?  No, but it might make Senator Nelson look like a buffoon.

And if that wasn’t enough, Dave Zimbeck provided a snarky reply to “the big conservative Bull elephant’s” (or bull-something’s) poison letter:

From: “Dave Zimbeck”
Date: Feb 9, 2018 1:11 PM
Subject: Re: Your investigation
To: “Stace Nelson” <Stace.Nelson@sdlegislature.gov

Your reputation for intolerance of views that are not exactly the same as yours is well-earned.  Glad to be a part of that club.

Keep up that constituent service!  First Frank Kloucek delivers for the district with kuchen,  and now you deliver on chislic.  All in the name of value added agriculture.  Hope it works for you.

Keep fighting us RINOs, big fella.

DZ

Frank Kloucek and Stace Nelson? That’s rarified air. Rarified air indeed.

EPILOGUE:  I corresponded with Mr. Zimbeck this afternoon, and he noted that yes, he did change his registration for a few months back in 2008. As in a decade ago. Why? In his words, he “did so in order to be able to cast a vote against Hillary Clinton.  At the time, it seemed that it was going to be my one and only chance to vote against her.”

Ultimately, I think most members of the Republican Party in the party would be ok with that. Many of us enjoyed that opportunity a year and a half ago.

However, there is always a dissenter or two. Considering the ‘high-level’ investigation he conducted against someone who thought his trivial ‘state nosh bill’ was absolutely trivial, those in the Senator Stace Nelson “conservative Bull Elephant” Party have a problem with someone switching parties to make a statement.

Fortunately for Mr. Zimbeck, that might be a party of one.

Apparently Stace Nelson tweeted this today…

And Dakota Posts was right on it:

Ouch…

Noem Talks Ag Policy on #FarmBillFriday 

Rep. Kristi Noem joined her neighbor, Eric Solsaa, to discuss the importance of the Farm Bill to producers, America’s food supply and our national security. The segment was featured as part of the House Agriculture Committee’s #FarmBillFriday program.

Hi everybody. I’m Kristi Noem. I’m the Congresswoman from South Dakota. I’m a lifelong farmer and rancher, raised cattle and crops for many, many years. I’m here at my neighbor’s house, Eric Solsaa. Tell us a little about your operation.

My dad and I run a purebred operation. We have about 150 cows. We’re in the middle of calving right now, and a farm bill is really important to us. We have row crops, 500 acres, and the rest is pasture.

You know, farmers can survive bad floods, bad hailstorms, bad weather and bad federal policy, but we shouldn’t have to. We can’t change the weather, but we can change policy. You know, you think about the fact that we have to grow our own food in this country. Everybody eats, not everybody farms. We cannot let another country grow our food for us, or they will control us. That’s why we have a farm bill, it’s important we have a safety net that provides some support for our farmers and ranchers, who take such a risk to grow this nation’s food.

This is a darned funny passage from an article about Billie Sutton running for Governor:

“If he can just get the state party to lay low,” says Mr Maher, “he has a fighting chance.”

Read that here.

You know it’s bad when someone notes a political party has to hide for the candidate to have a chance.

Noem-Backed Bill to Improve Rural Call
Quality and Reliability Sent to Trump

Washington, D.C. – The U.S. House of Representatives today passed the Improving Rural Call Quality and Reliability Act, which Rep. Noem helped introduce in the House in January 2017.  Persistent phone call completion problems in rural communities are creating major inconveniences for families, hurting businesses and threatening public safety.  The legislation would direct the Federal Communications Commission (FCC) to establish basic quality standards for providers that transmit voice calls to help ensure businesses, families, and emergency responders can count on phone calls being completed.

“Companies in the business of routing voice calls sometimes purposefully drop long-distance calls headed for remote areas as a means to save money,” said Noem. “While even the sheer inconvenience is inexcusable, some of these calls involve emergencies, leaving rural families in an unnecessarily dangerous situation. This legislation simply requires that basic quality standards for providers that transmit voice calls be established, helping ensure businesses, families and emergency responders can count on phone calls being competed.”

The Improving Rural Call Quality and Reliability Act initially passed the House in January 2017. Due to recent amendments by the Senate, the House passed the legislation again today, sending it to President Trump for signature. The legislation is supported by the South Dakota Telecommunications Association, among others.

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Thune, Carper Introduce Legislation to Add Certainty to Chronic Care Coverage in HSA-Eligible, High-Deductible Health Plans

WASHINGTON — U.S. Sens. John Thune (R-S.D.) and Tom Carper (D-Del.) this week introduced bipartisan, bicameral legislation to ensure that high-deductible health plans (HDHPs) used with health savings accounts (HSAs) can opt to cover care related to chronic disease management prior to a beneficiary reaching their plan deductible.

Recognizing the growing prevalence of HSA-eligible HDHPs, the Chronic Disease Management Act enables plans to offer coverage of high-value services to patients that can improve outcomes and reduce complications. The legislation creates a chronic disease prevention safe harbor, permitting the pre-deductible treatment of a medically complex condition that is substantially disabling, has a high risk of hospitalization, and requires specialized care.

“This bill is a win for patients and the health care system overall,” said Thune. “Importantly, it helps patients with chronic conditions access the care they need and expands the principles of value-based insurance design by promoting proper management of these conditions. Doing so will prevent the need for more costly treatments down the road.”

“Four in 10 Americans with health insurance have a high-deductible health care plan” said Carper. “This bill helps ensure those individuals with high-deductible plans can get better access to the basic care they need to stay as healthy as possible, without the fear of triggering their deductible.”

“We applaud the efforts of Senators Thune and Carper and Representatives Black and Blumenauer in authoring this critical legislation to ensure that patients with chronic illnesses have access to needed care and to help Americans get more health out of every health care dollar spent,” said Andrew MacPherson, co-chair of the Smarter Health Care Coalition. “We urge Congress to swiftly pass it.” The Smarter Health Care Coalition is made up of patient groups, employers, life science companies, health plans, and public sector purchasers.

In 2016, Thune and Carper pressed the U.S. Department of Treasury to improve the definition of the existing preventive care safe harbor in federal law to include preventive care related to chronic illness.

Companion legislation has been introduced in the U.S. House of Representatives by Reps. Diane Black (R-Tenn.) and Earl Blumenauer (D-Ore.).

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From the State Legislature:

I wasn’t aware that they were teaching anything like that in Kindergarten.

The legislature sometimes has a tendency to get into what is and isn’t taught in schools too much in the first place.

If we believe in less government, and preach less government, then we should actually practice less government. If we want local control, then let them figure it out locally.