COLUMN
PRESIDENT’S REPORT STEVE ALLENDER
One way or the other, through a bill or ballot measure, the question of Medicaid expansion is on the table. Generally speaking, I would consider myself of average ignorance when it comes to Medicaid, but after doing some of my own research I may have overestimated my knowledge. Medicaid coverage exists and provides benefits to certain elderly, disabled or low income individuals. The calculation for eligibility for low income is based on the federal poverty level (FPL). Medicaid expansion would change the eligibility requirements to allow more South Dakotans to be enrolled. Currently, there about 141,000 enrolled in our state and expansion would increase that an additional 42,000.
PROPOSED EXPANSION OF MEDICAID COVERAGE BASED ON FEDERAL POVERTY LEVEL Eligible Persons
Current Income Level - 100% of FPL
Proposed Income Level - 138% of FPL
1
$12,880
$17,774
2
$17,420
$24,039
3
$21,960
$30,304
4
$26,500
$36,570
5
$31,040
$42,835
There are many reasons why we should be considering Medicaid expansion. Approximately 11% of South Dakotans are not covered by health insurance. This equates to financial strain on workers and a slew of unpaid medical bills. This is just as true in the private sector as it is in the public sector. At this moment, there are 14 South Dakota rural hospitals at immediate or high risk of closing. The common denominator between them is lack of medical payments either from insurance or cash customers. Geographically, South Dakota is primarily rural in nature, so this poses a healthcare risk to many of our fellow citizens. Expansion would extend a lifeline to rural hospitals by providing coverage to more people. All of South Dakota’s medical providers bear the burden of absorbing costs… or passing them on to other customers
when patients cannot afford to pay their bills. Expansion would greatly reduce the number of unpaid bills by providing payment for customers previously unable to pay. Private and public ambulance services are all at risk of going in debt or closing. The only viable option on the table today to avoid this is creating a new taxing district – not a very popular idea in South Dakota. Expansion would cover a larger segment of the population’s ambulance bills and provide a much-needed reimbursement for services. The State of South Dakota stands to save millions of dollars annually while improving quality of life for tens of thousands of people. Currently, many medical-related services are provided by the State out of general funding. Behavioral health, inmate care and other social programming would benefit greatly from expansion and relieve the State of expending general fund tax dollars in many cases. With the extra incentives being offered from the federal government, the state would stand to save more than $60 million each year for the first two years of expansion. After that, the savings is estimated to be approximately $11 million annually. While it’s true your federal tax dollars will be used to expand Medicaid, the State and local tax dollars you pay would go further in providing essential services. Obviously there’s more to learn about this entire process, but know this: so far, 39 states have chosen to expand Medicaid. The holdouts are South Dakota, Wyoming, Wisconsin, Kansas, and states in the deep South. Even conservative states such as Idaho, Nebraska, Utah, Oklahoma, and Missouri have opted to expand. Please keep your mind open and afford yourself a chance to learn the facts about Medicaid expansion. ■
sdmunicipalleague.org | 1.800.658.3633
5
