Week 6 of the 2014 South Dakota legislative session dealt with Medicaid Expansion bills.

House Bill (HB) 1210 went before the House State Affairs committee on Wednesday afternoon and AARP South Dakota testified in favor of it.  HB 1210 expanded Medicaid to 138% of the Federal Poverty Level (FPL) and AARP South Dakota supports full expansion of Medicaid to our low-income, hardworking South Dakotans. 

With full Medicaid expansion, 12,000 South Dakotans age 45-64 would have access to health insurance coverage.  As we know, South Dakotans eligible for Medicaid expansion are making very little in wages and are likely not offered health insurance or are unable to afford it.  Expanding Medicaid for these midlife individuals could keep them healthy and participating in the workforce longer.

People without healthcare coverage are far less likely to access recommended preventive and screening services—such as flu shots, cholesterol screening and mammograms.  The ability to access preventive services and health screenings means that people can avoid contracting certain illnesses and/or have their conditions diagnosed and treated much earlier.  Expanding Medicaid will give uninsured low-income South Dakotans access to lifesaving screenings and preventive services. 

We all know our federal government needs to get its fiscal house in order and the country faces many tough budget decisions.  However, the federal government will pay 100 percent of the cost of a state’s full Medicaid expansion for three years beginning in 2014.  This means that the federal government will be paying all of the healthcare costs for people when their untreated health conditions are likely to be more expensive. 

Proponent testimony for HB 1210, which was sponsored by Representative Scott Parsley, included AARP South Dakota, South Dakota Community Action Partnership, American Cancer Society, South Dakota Association of Hospital Organizations, Avera Health, Oglala Sioux Tribe, Rapid City Regional Health, Community Healthcare Association of the Dakotas, Sanford Health, South Dakota Nurses Association and the South Dakota State Medical Association.  Opponent testimony was from the South Dakota Department of Social Services and South Dakota Bureau of Finance and Management. 

Opponent testimony asked that HB 1210 not pass because Governor Daugaard has not received a response for his Medicaid expansion waiver request from the Federal Government.  If you’ll recall, AARP South Dakota opposes the Governor’s waiver request because, in part, it only covers 100% of the FPL.

Ultimately, HB 1210 was defeated in House State Affairs on an 8-5 vote.  Representatives Conzet, Gosch, Novstrup (David), Verchio, Westra, Wink, Cronin and Lust voted to defeat the bill.  Representatives Gibson, Hunhoff (Bernie), Killer, Munsterman and Parsley voted for the 1210 and to move to the floor of the House of Representatives.

HB 1239 is a Medicaid Expansion bill that was debated in House Health and Human Services (HHS) committee this week.  HB 1239 is similar to the Governor’s waiver request in that it offers Medicaid expansion to 100% of the FPL but unlike the Governor’s waiver request, HB 1239 does not have a work requirement. Again, AARP South Dakota supports full Medicaid expansion up to 138% of the FPL and could not support HB 1239. The bill was defeated on a 9-3 vote in House HHS.

House HHS passed HB 1244, pitched by Representative Scott Munsterman as an alternative to Medicaid expansion, this week and it moves to the House floor next week.  HB 1244 would apply to people earning up to 100% of the FPL and has many parameters that prevents access to health insurance coverage.  To receive coverage under HB 1244, individuals would have to be ineligible for Medicaid, Medicare or the Indian Health Service, work 40 hours per week and pay $25 per month for coverage.  HB 1244 would cost $14 million in state funds for the 4,000 South Dakotans eligible.  The bill is funded in part by removing property tax exemptions for health care facilities.

Governor Daugaard, hospitals, nursing homes and AARP South Dakota oppose HB 1244.  AARP South Dakota agrees with Governor Daugaard that HB 1244 is very expensive and the costs of removing the property tax exemptions for health care facilities would be passed onto health care consumers.  HB 1244 also undermines Medicaid expansion and it comes with higher costs that would cover fewer low-income residents.

At your legislative forums this weekend tell your legislators from the House of Representatives to oppose HB 1244.

The question of the week is:
If the Governor’s Medicaid expansion waiver request is denied by the Federal Government while the legislature is still in session; what action will you and the legislature take to address this issue before the session concludes?

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