South Dakota Democrats have called on the state to expand Medicaid to lower-income adults who currently don’t qualify for the state’s plan. In a release, Rep. Bernie Hunhoff said Democrats will make the expansion a priority during this legislative session.
“Nothing could be more pro-life than to expand Medicaid as soon as possible,” Hunhoff said in the release.
The expansion was part of the Affordable Care Act, better known as Obamacare. But recall the Supreme Court decision from this summer. The Court upheld the requirement for an individual mandate to buy health insurance, but it struck down the requirement that states expand Medicaid (the 1987 decision in South Dakota v. Dole played a prominent part in the Court’s decision on Medicaid). So that left it up to the states.
Prior to the election, Democrats weren’t unified on the issue. Some, uhm, ducked the question. But now it looks like the party is fully unified. They argue that the federal government will pick up most of the cost, so why not?
Expanding the program would allow 40,000 to 50,000 more people qualify. Currently, about one out of every seven residents is in the program, mostly children.
Democrats, citing a study from the Center on Budget and Policy Priorities, say expanding the program would bring $2.1 billion in federal funding to the state over 10 years. In return, the state would pay between $9.5 million and $15.7 million a year.
Not a bad tradeoff, assuming the federal government has the money to pay its obligation. And that’s no sure thing, given the climate in Washington.
But, the state already has trouble paying for the system it has. Budget cuts to education and other programs in the last couple of years were caused in part by increasing costs in Medicaid. Meanwhile, the governor has said he doesn’t want able-bodied adults growing more dependent on government, which he thinks would happen if the program is expanded. Voters rejected a plan to raise the sales tax to generate about $90 million a year for Medicaid.
So we will have another defining issue between the two parties during this legislative session. Most Republicans are likely to say no thanks to the federal dollars that would come with expansion. The state can’t afford it, they’ll say. Democrats will try to claim the moral high ground, arguing that expanding medical care to the poor is the right thing to do.
Clear, defining issues, are a good thing.