South Dakota Governor Dennis Daugaard says he doesn't plan to expand Medicaid in South Dakota under the Affordable Care Act.
Under the new health care law, states have the option to expand Medicaid to those who don't qualify for subsidies under the law, but who also don't make enough money to buy health insurance on their own.
About 48,000 South Dakotans fall into that category. The federal government will pay for a majority of the costs, and while the governor is hesitant to grown the program, the legislature may push for the expansion.
Daugaard told lawmakers during his annual budget address last week that the federal government has been too unreliable and that's why he's decided not to expand Medicaid in South Dakota.
"I am not recommending to expand Medicaid in FY2015 budget. The implementation of the Affordable Care Act continues to be unpredictable and chaotic," Daugaard told lawmakers.
The expansion would mean anyone making less than $15,000 a year or a family making less than $32,000 a year could be covered under Medicaid. The federal government would pay for the entire expansion for the first few years and then scale funding back to 90 percent by 2020, with states picking up the other ten percent. It's why South Dakota Democrats including State Senator Angie Buhl will keep pushing for expansion.
"Without expanding Medicaid, we're leaving money on the table. We're subsidizing the folks in other states through our federal taxes who are expanding Medicaid. So, I think this is really a win-win option for South Dakota," Buhl said.
South Dakota is one of 20 states that has declined to expand Medicaid under the Affordable Care Act. Buhl says there will likely be a push during the upcoming session to strike South Dakota off that list.
"I think there will absolutely be an ongoing discussion legislatively as we get into session and really explore options other than the governor's office deciding to take the lead on this - really push South Dakota to expand Medicaid. It's definitely an ongoing consideration," Buhl said.
Buhl says there is no risk to the state because if the federal government doesn't pay its share of the expansion, South Dakota can drop the coverage at any time. That's why Buhl only sees benefits in expanding Medicaid to provide coverage to thousands of working poor in South Dakota.
"We're talking about hard-working people who just need help making ends meet and this is a great way to help do that," Buhl said.
Medicaid expansion will take effect on January 1 in the states that have decided to make the changes. It does not mean, however, that South Dakota cannot expand the program. The state can opt in at any time.