Medicaid expansion is part of the Affordable Care Act and it became an issue for us when the Supreme Court ruled that the Federal government couldn't force states to expand Medicaid as part of the overall plan to get as many people with health coverage as possible.
According to the U.S. Census Bureau, there were more than 105,000 South Dakotans who lacked health insurance in 2011, or 13 percent of the state population. We estimate there are about 40,000 people who would qualify for Medicaid under expansion.
We know that people lacking health insurance are less likely to get recommended preventive screenings. And they are more likely to receive inadequate treatment for chronic diseases. But people enrolled in Medicaid have better access to health care than those who are uninsured.
Studies show that people enrolled in Medicaid receive lifesaving preventative screenings at higher rates than the uninsured and at close to the same rate of people enrolled in private insurance.
Participation in the Medicaid expansion will allow more people in South Dakotans to see a doctor regularly, access preventive care such as weight and nutrition counseling, blood pressure screenings, and smoking cessation treatment and avoid unnecessary visits to the emergency room.
Access to these critical services increases the likelihood of detecting chronic illnesses such as obesity, hypertension and heart disease at an earlier, more treatable and far less expensive stage.
Starting on Jan. 1 of 2014, states who grow Medicaid get the expansion covered 100 percent by the Federal government through 2016. Then the match starts to decrease but it's still covered largely by the Federal government. Unfortunately, South Dakota is missing out on tens of millions of dollars each year we don't grow Medicaid. And 25,480 people in SD are stuck in the coverage gap - they don't qualify for Medicaid now and aren't eligible for subsidies on the federally run health insurance exchange.
There are misconceptions on this issue. To qualify for Medicaid now in South Dakota, you need to be making an income at 54 percent of federal poverty or $10,529 per year. It is a misconception that disabled people automatically qualify somehow, and that's not true. You have to be disabled AND quite economically challenged.
Our governor and legislature have been willing to expand Medicaid up to 100 percent, as long as they can prove they are working or actively searching for a job. The federal government has considered that and said that's not going to work and therefore won't approve a waiver for our state.
We believe this is an issue that works for our state because of the impact on economic development. South Dakota would not turn down hundreds of millions in federal highway funding dollars. What’s more, healthy people are more productive and save dollars in the long run.
We all pay in higher health care costs and higher insurance premiums when people don't get those preventive care and hospitals have to write off millions in unpaid medical bills.
We plan to engage our grassroots on the importance of everyone having access to health care. Our volunteers understand that prevention is key.
Medicaid expansion is something that will happen eventually, and we need to put together a solution that works for our rural, conservative state. It's a natural fit for the American Heart Association to be leading the charge and we will work on behalf of all South Dakotans to get this done.