South Dakota voters to decide Medicaid expansion after bill fails

(The Center Square) – A bill that would have expanded Medicaid in South Dakota has been voted down in the Senate, which leaves the decision up to South Dakota voters in November.

A proposed constitutional amendment will be on the ballot in November. Sen. Wayne Steinhauer, R-Hartford, said approval by the Legislature was a better alternative than voter approval.

“If it gets into our constitution, it’s not just here for just a few years,” Steinhauer said during debate Monday before the Senate voted, 23-12, against the blll. “It’s here for decades.”

The bill would hurt the state’s budget, particularly in the area of K-12 education, Sen. Lee Schoenbeck, R-Watertown, said.

“I don’t think more welfare is going to make our state a better state,” Schoenbeck said. “If the voters chose to do it at the ballot box, then they are going to have to live with the results and the budget consequences of it.”

Medicaid expansion is not backed by Gov. Kristi Noem’s administration.

The bill could cost the state an additional $456 million a year in ongoing expenses and require 64 additional full-time employees, Laurie Gill, secretary of the Department of Social Services, said earlier this week.

Steinhauer said the bill would erase $1 million in indigent care and generate money for the economy.

“This is going to result in $300 million of federal and state money infused into our economy,” he said. “Now if that just turns two times outside of the health care industry – we don’t collect sales tax on health care – that would generate $27 million.”

Before the vote, Steinhauer said the bill is “about people.”

“I just suggest, pause and listen to your heart,” he said

The bill’s defeat puts its approval up to the voters. The Secretary of State’s Office announced in January enough signatures had been gathered to put it on the November ballot.

If approved, the amendment would extend Medicaid to South Dakota residents between the ages of 18 and 65 with an income 138% below the poverty level.

Medicaid expansion has the support of health care organizations and the South Dakota Municipal League (SDML).

“The workers in communities all across our great state are working jobs that South Dakota depends so heavily upon – those jobs in the service industry, tourism and agriculture,” Steve Allender, president of the SDML and mayor of Rapid City, said this week at a Senate hearing. “And it could be the bulk of these workers in these industries may not make enough money in wages to purchase their own health insurance. And Medicaid expansion could be a lifeline for them as well something that strengthens the foundation of South Dakota’s most important industries.”

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