South Dakota governor to announce if he will pursue Medicaid expansion

South Dakota Gov. Dennis Daugaard's office said Friday that he will announce next week whether he'll pursue an expansion of Medicaid.

The governor is set to make the announcement Monday, after getting input Friday from federal officials about policy revisions necessary to satisfy his conditions. Daugaard said earlier this week that he was "increasingly optimistic" the state would have the means to expand Medicaid.

He would also need to sell the plan to lawmakers and the state's Native American tribes.

Daugaard has proposed expanding eligibility to roughly another 50,000 South Dakota residents, as long as the state's share of the cost is covered by other savings. His stance marks a departure from many other Republican governors who have resisted expanding Medicaid as part of the federal health care overhaul.

In a letter sent to state officials Friday, the U.S. Department of Health Human Services outlined policy revisions that may help accommodate a potential expansion in South Dakota.

The letter says the federal government will use Medicaid dollars to fully fund services for Native Americans who are eligible for Medicaid and receive care from providers outside Indian Health Service, as long as the provider has an agreement with IHS or a tribal facility. The state's proposal hinges on whether some services for Native Americans who are eligible for Medicaid can be fully funded by the federal government.

Currently, there is a rough split in financing between the state and the federal government when people who are eligible for Medicaid but can get services through IHS go to an outside health care provider. The changes could reduce current state spending to be put toward expansion.

The governor is evaluating the policy revisions, chief of staff Tony Venhuizen said Friday.

Daugaard formally proposed broadening eligibility for the health coverage program for low-income and disabled people at his budget address in December.

The legislative session ends March 11, meaning the governor and lawmakers don't have much time to debate the proposal. Daugaard acknowledged the time constraints Thursday, saying he needs to evaluate whether the Legislature would be willing to dive into the plan.

Republican Rep. Don Haggar, an opponent of Medicaid expansion, said the changes should improve access to health care for Native Americans in South Dakota. But, he said it would be a mistake to try to push through Medicaid expansion this legislative session.

"I feel like it would be a hasty decision," he said.



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