SIOUX FALLS, S.D. (AP) — A South Dakota task force says expanding Medicaid in the state would improve access to preventative care and lower mortality rates, but it would also overload doctors and nurses and limit the state’s flexibility in expanding health coverage.
The 29-member Medicaid Opportunities and Challenges Task Force, appointed by Gov. Dennis Daugaard to investigate the pros and cons of expanding Medicaid in the state, issued its final report this week.
Under the Affordable Health Care Act, the federal government will cover the entire cost of a state’s new Medicaid enrollees from 2014 through 2016 before the federal share begins to gradually drop to 90 percent.
The report said the financial impact of expanding Medicaid in South Dakota will be “considerable,” jumping to $36.8 million by 2020. The cost estimate includes the state share of 5 percent in 2017, 6 percent in 2018, 7 percent in 2019 and 10 percent in 2020 and beyond.
But expanding Medicaid would help the state leverage federal funds and provide financial relief for South Dakota hospitals dealing with uncompensated costs, the report said.
“This financial relief will have a positive impact on hospital employees, contractors and the larger business community that rely on the financial health of local hospitals,” the report said. “Other providers will also financially benefit from an increase in the number of insured citizens, although the actual impact will vary by provider.”
The Legislature this year opted not to expand the federal-state program that covers the medical expenses of low-income people, but states can change their decision at any time.
Daugaard then assembled the task force to research the issue, gather input and complete a report that outlines the advantages and disadvantages of an expansion. The panel made up of lawmakers, doctors, behavioral health providers, dentists, community health providers, hospital officials and state workers was not asked to recommend whether South Dakota should expand Medicaid.
The report included several recommendations, if the state were to expand Medicaid. Among them: terminating the program if federal funding drops below 90 percent, creating financial incentives to keep people healthy and monitoring the quality of care.
The task force also evaluated arguments related to the issues of equity and fairness resulting primarily from the unintended consequences of the U.S. Supreme Court’s decision making Medicaid expansion optional for states. The report noted that expanding Medicaid is the only way to ensure that individuals below 100 percent of the federal poverty level will receive subsidized health insurance.