PIERRE, S.D. (KELO) — South Dakota joined many other states this summer when the Medicaid program was expanded to allow more people to be financially eligible.

Voters approved a constitutional amendment in November, and the expansion took effect on July 1. Adults can now make up to 138% of the federal poverty level. According to state Social Services Secretary Matt Althoff, enrollment specifically from the expansion reached 10,164 in September.

That was about one-fifth of the 57,000 forecast in a January 2022 study. Althoff met Monday with the Legislature’s Appropriations Committee. He told lawmakers that he still believes the estimate will be reached, but it might take 24 months to get there, based on experiences in other states.

“We’ve seen a very steady enrollment,” Althoff said. “Sioux Falls by far has received the most number of applications.”

According to the secretary, three of four adults enrolling because of expanded eligibility hadn’t been in the Medicaid program during the previous year.

Republican Rep. Mike Derby is the panel’s co-chair. He said some lawmakers didn’t believe there would be 57,000 enrollees on July 1 but still funded it, including providing 68 more staff. Derby asked why the state Department of Social Services is paying overtime.

“I struggle a little bit with it myself too,” replied Althoff. “We were not on the A game as a department because we were new to it.”

Democratic Rep. Linda Duba asked how the department is promoting the expansion. “There is concern out there we are not doing enough to inform those lower-income people,” she said.

Althoff said the department is striving to process applications in a timely way and continues to canvass the medical provider networks that refer patients to the program. He said the adults enrolling as a result of the expansion are seeking medical services immediately. “That is a very different dynamic that we’re still learning about,” he said.

Duba asked, Does the department track whether its specialists tell enrollees in other programs about expanded Medicaid eligibility? Althoff said the specialists are “very conscientious” and that many new Medicaid enrollees also have enrolled in the SNAP food-support program. He also said there’s been “a major increase” in online Medicaid applications, which reduces the opportunities for department staff to converse with those applicants.

“Can we see that in data going forward?” Duba asked. Althoff said he’s confident the specialists tell applicants in other programs but he wasn’t sure whether the data is tracked.

Here’s a look at the month-end enrollment numbers since Medicaid expansion took effect in July according to the department website.

July — 4,125 expansion enrollees were 3.42% of a total 120,725 Medicaid enrollees.

August — 7,478 expansion enrollees were 6.19% of a total 120,733 Medicaid enrollees.

September — 10,164 expansion enrollees were 8.41% of a total 120,881 Medicaid enrollees.

October — 12,623 expansion enrollees were 10.34% of a total 122,067 Medicaid enrollees.

See the department’s handout here.