Medical Community Debates Budget Proposal

by Breanna Fuss, Reporter
December 05, 2012 6:26 PM


Governor Dennis Daugaard’s 2014 budget proposal has left more than just lawmakers talking. Medical providers are a big part of a conversation regarding health insurance. And with thousands of South Dakotans with it, they are expressing concern.

Over 48,000 South Dakotans are uninsured. Those who work in the medical field said they are happy about the 3 percent increase Medicaid providers will receive, however, they said there is much more to the Medicaid debate that needs discussing.
 
"I am not recommending that South Dakota expand its Medicaid program in the fiscal year 2014,” said Governor Dennis Daugaard.

Governor Dennis Daugaard said he has proposed a conservative plan and that is one reason why he doesn’t want to expand the state’s Medicaid program to be apart of the Affordable Care Act.  

He also said there are too many uncertainties.

"There are too many unanswered questions for me to recommended adding 48,000 adults to the 116,000 already on our roles,” said Daugaard.

Medical providers said they applaud the governor for saying he will meet with President Obama to get those questions answered.

But until then, not expanding the program creates an area for concern.
          
"The expansion would offer them an opportunity for coverage, but also provide them an opportunity for preventative care,” said Erik Nelson, AARP Associate State Director of Advocacy

That means when a person is sick they would be able to go to their doctor that is covered by insurance. But doctors said those who aren’t able to get health insurance are instead seeking out a different type of medical care.
 
"A sore throat, an earache, if you will. Things that can easily be taken care of at a doctors office, but they don’t have access to the doctors office. So the emergency room basically serves as their safety net,” said Dr. Daniel Heinemann, President Elect of the South Dakota State Medical Association.

And even though those patients are uninsured the Medicaid Program pays for those visits anyway.
     
That has medical providers and doctors alike saying this discussion are not over yet.

“We understand it is a financial issue for the state, but we believe, that our patients and the citizens of South Dakota need to have access to that,” said Heinemann.

If the state were to sign on with the Affordable Care Act the federal government would pay 100 percent of the costs for those new Medicaid users claims for the next three years.

Daugaard said by 2017, the state would pay 5 percent of the cost and the federal government would pay 95 percent. By 2018 the state would pay 6 percent and the federal government would pay 94 percent. And by 2020 the state would have to pay 10 percent of the claims and the federal government would pay 90 percent. By 2020 Daugaard estimates the state would be paying over $43 million extra a year in Medicaid costs.

The governor also says he’s not sure if this is an all or nothing deal. He says he doesn’t know if the state were to expand the program if all 48,000 uninsured South Dakotans would have to be covered. However, all sides plan to continue the discussion.