Sunday, August 7, 2016

Mike Pence Found A Way To Expand Medicaid In Indiana, So Why Can't Daugaard Do The Same In South Dakota?

      South Dakota Republicans should get behind their state's party leader, Governor Dennis Daugaard, and show him some support on Medicaid
Arguing For Medicaid Expansion
Pence Did It For Indiana
It's an issue that shouldn't be polarized into political camps but one that really needs to be addressed on a utilitarian basis.  "Utilitarianism," as a political and economic set of beliefs, boils down to the principle that policies that lead to the greatest good for the greatest number of people should be the ones pursued and implemented by their governments.  Expanding Medicaid fits this definition to a tee, considering that it will add about 50,000 South Dakotans to the Medicaid rolls, taking pressure off of state resources to provide them with healthcare and give South Dakota medical providers a chance to reduce the losses that accrue from caring for people without insurance.  

     If Daugaard's opinion and plans aren't persuasive enough to our legislators to show the govenor some support, they might consider Indiana Governor (and GOP Vice-Presidential nominee) Mike Pence's attitude toward the program that he adopted in Indiana.  Pence created a plan that provides Medicaid coverage for 350,000 residents who make up to 138 percent of poverty level wages (about $16 k/year for individuals, $33 k/year for a family of four).  He attached some strings to the program, which is called Healthy Indiana 2.0, that requires enrollees to pay into health savings accounts, which may be a tweak worth considering in this conservative state of ours.  The plan's website doesn't provide a table, but touts the premium as an "affordable, monthly contribution . . . based on your income."  Indiana's 350k enrollees amount to nearly 6% of the state's population, about the same percentage as our 50k potential enrollees here.
     According to Politico, Pence's program went through despite "upsetting many conservatives who saw the move as betrayal." No doubt Daugaard, regardless of what method for expansion he promotes, will get similar pushback from South Dakota lawmakers.  The ideologically hidebound House Majority Leader Brian Gosch (R-Rapid City) told the Sioux Falls Argus Leader  last June that a block of elected Republican lawmakers don't support expansion because "they know it's bad for the state and for the country."  But like Pence, partisan oppostion like that shouldn't deter Daugaard, because like Pence our governor understands that the money pouring in for Medicaid expansion does the greatest good for the greatest number of South Dakotans.  I invite Gosch and the other naysayers to examine how Medicaid expansion has worked, even in conservative states like Indiana, then I challenge them to find a way of making it work here.
He Ain't No Dummy.  But Some SD Pubs?
I'm Not So Sure.

     These intransigient Republicans need to explain why they oppose Medicaid expansion when two of the most conservative Governors in the United States found it to be something workable and worthwhile in their respective states.  In the meantime this ideological inflexibility should be considered by voters in November who are just plain sick and tired of reflexive hatred toward a plan that promises to do us some good just because it was spawned by the Obama administration.


  1. Call me a conspiracy theorist, John, but just like at the federal level, where I think that there are more powerful people behind the scenes acting as puppeteers with the presidents that we have elected for the last several election cycles, It appears that the same thing has happened at the state level as interests outside the state are maneuvering what happens politically in our state. To heck with what is best for the State and the people.

  2. My grandfather was wont to observe that just because you're paranoid, doesn't mean people are not out to get you!