Tuesday, September 29, 2015

OMG! Man Bites Dog! Sun Rises In The West! Daugaard Wants To Accept Medicaid Expansion!

     Well shut my mouth and call me cornpone.  It looks like after years of being harangued by
Hello, Governor Daugaard?
Try Calling 1-800-Medicaid Expansion
(photo from dennishouse.tv)
logic and common sense, South Dakota Governor Dennis Daugaard is finally taking the plunge and offering a potentially workable deal that would expand Medicaid into South Dakota.  Though he's "never said never" to Medicaid expansion according to Daugaard's son-in-law and spokesman Tony Venhuizen, the claim that Daugaard's intent has always been "finding a plan that works for South Dakota" comes right out of the standard PR playbook as a euphemism for "waking up and smelling the coffee."  Though Daugaard has in the past left the door open a crack for expansion, there doesn't seem to have been much effort made toward crafting "a plan that works for South Dakota," at least that I'm aware of. And if there has been, I'd say Daugaard's vacillation over the years would make Hamlet seem resolute.

     The deal that Daugaard wants to strike would expect the feds to pony up more funding for the Indian Health Service so that IHS doesn't have to continue tapping into Medicaid for payment, some of that money coming from SD state resources.  If that turns out to be a dealbreaker it would amount to saying (in Cory Heidelberger's concise conclusion over at Dakota Free Press) "if Uncle Sam doesn't take care of Indians, we're not going to take care of 48,500 other South Dakotans."  I'll chime in with Cory's assessment:  "nuts to that."  
     I think Daugaard has finally reacted to the economic realities of the situation.  It probably has taken a funding crisis like the one South Dakota is in right now for the governor to understand the
economic aftereffects of Medicaid expansion.  The economy has been sluggish and continues to
compare unfavorably with all but 10 other states in the country.  Meantime we have a teacher salary problem of epic proportions and have had to jack up taxes to fix our long ignored highway infrastructure.  So all of a sudden, the powerful financial numbers that are provided by Medicaid expansion must look awfully tempting to a state administration that must be scrambling to find new sources of money or some kind of economic boost.  How the deal provided by Medicaid expansion can be ignored at this point seems illogical and inexplicable.  The non-partisan South Dakota Budget And Policy Institute looked at this a couple of years ago and concluded that federal dollars coming into our state would amount to billions (with a "b") and cost the state millions (with an "m"). That's a pretty good trade when you consider that the inflow of Medicaid money will rollover in the state's economy a few times, generating local and state taxes like crazy.  
     No doubt there are some vestigial pessimists about Medicaid's future in the ranks of South Dakota's political leadership, mainly because expansion is tied to the Affordable Care Act, which is still the subject of partisan hatred by many Republicans.  My guess is that they fear the political consequences of first giving Medicaid to nearly 50,000 South Dakotans and then trying to snatch it away by repealing ACA. Considering that ACA has survived every legal and political challenge it's faced thus far, the prospects of it going away get dimmer by the year.  And even then, if it goes away, it goes away.  We'll just be stuck with re-instituting the status quo.  In the meantime, a ton of money will get heaped on South Dakota.  I'm glad to see that Governor Daugaard is finally making a real effort at collecting it for us.  

Here's Something Worth Considering:

     Also, here's a Rand Corporation 2013 analysis that concludes "states would do best to expand Medicaid"  (added 10/1/15 @ 0749)


  1. Maybe one of Daugaard's relatives isn't covered yet. Bill Janklow did not get interested in diabetes coverage and research until he got it himself. One of the GOP's good old ladies in state government firmly opposed mandatory seat belt laws until she herself saw the benefits in a crash.

  2. Nothing to see here folks. The SD GOP (Grope Our Panties) regularly rails against the central government, but at the first hint of budgetary shortfall the state government goes running to the 'guvment' with an outstretched hand. If it wasn't for the fact that the money (minus what the state will surely siphon off) will improve the lives of thousands I would like to see the Obama Administration respond: Y'all made your bed, so sleep in it!