SIOUX FALLS, S.D. (KELO) — In one month, an estimated 52,000 South Dakotans will have new access to healthcare coverage through Medicaid. 

That’s because South Dakota voters approved Medicaid expansion through Amendment D (56%-44%). Starting July 1, people who are age 19 but not yet 65 and have an income up to 138% of the Federal Poverty Limit can apply for Medicaid, which is the federal and state health insurance program. 

Dr. Jennifer Tinguely, the Chief Medical Officer at Falls Community Health, explained people now eligible for Medicaid include a single person making less than $20,000 or a family of four making less than $41,000.  

“Medicaid expansion was a huge win. Something that we’ve been begging for for years,” Tinguely said at an event hosted by healthcare advocacy organizations. “I’m excited for our providers, our nurses, our whole team here that we are now going to have more options for our patients that truly need that care.” 

Tinguely is a family practice physician and sees patients of all ages. She said currently 50% of the patients she serves are uninsured. She said Falls Community Health will continue to serve patients without health insurance, but she believes Medicaid expansion will help expand ways to provide care. 

“There’s a lot of assistance programs, but boy it makes the process a lot easier if you can just seamlessly do things the way we were trained to do,” Tinguely said. “I absolutely know that we will have more patients that have insurance, which does improve the bottom line. So that’s a good thing.”

Dr. Dan Johnson, a retired doctor from Yankton, said hospitals, nursing homes and EMS services in rural South Dakota will also benefit from Medicaid expansion. 

“This is going to be a lifeline to a lot of those services that struggle to exist in rural communities,” Johnson said. “It’s going to be a big deal to make them more financially solvent.” 

Some state lawmakers and people opposed to Medicaid expansion are worried about the future costs related to the program in future years. There were also concerns about healthcare becoming harder to receive because more people would be insured. 

Tinguely said quite the opposite. She said healthcare organizations like Falls Community Health are excited for the opportunity to provide more care to people who need it. 

“The doors are open. We’re ready,” Tinguely said. “We’ve got a very robust staff here at Falls Community Health. We have about 30 providers that are here to see patients anytime, so we’re not worried.” 

How many people use Medicaid? 

The estimated 52,000 South Dakotans eligible for Medicaid expansion comes from the Department of Social Services and the Bureau of Finance and Management. It was a 10,000 increase from the 42,000 originally estimated by the South Dakota Legislative Research Council for the Amendment D ballot measure. 

In January 2023, there were 151,640 eligible South Dakotans for Medicaid, which dropped to 139,770 in April 2023, according to the latest monthly report from DSS

DSS estimated 22,000 people would lose Medicaid coverage from “Medicaid unwinding” from the end of the federal COVID-19 emergency that kept states from removing people from Medicaid. 

State Medicaid director Sarah Aker told the South Dakota Board of Social Services in April it was challenging to track how many of the 22,000 people would be eligible for Medicaid after expansion starts July 1. 

DSS has been planning to hire 68 new full-time positions to help handle Medicaid expansion. 

In January, DSS Deputy Secretary Brenda Tidball-Zeltinger said Amendment D is the biggest change to the program in 25 years. She said DSS officials worked with other states on how Medicaid expansion has worked. 

In a May presentation to lawmakers on the Joint Committee on Appropriations, DSS said its systems were on track for implementation starting July 1. 

Erik Nelson, with South Dakota AARP, said there should be no impacts on Medicaid expansion applications and the enrollment process. He said people should contact DSS and use the DSS website for resources related to eligibility, covered services, costs and other questions.