That Sioux Falls paper is dribbling out a new Mason-Dixon poll that finds South Dakotans want to expand Medicaid under the Affordable Care Act. The poll finds 45% in favor, 37% against. Hey, if that margin is enough to elect a U.S. Senator, it should be enough to make a policy decision.

That's a remarkable drop from a January 2014 poll, conducted by GOP pollster Glen Bolger, that found 63% of South Dakotans favoring the Medicaid expansion. Perhaps so close to an election, a large chunk of voters can't help noticing the cognitive dissonance between their thoughtful values and their ingrained, automatic, inertial reach for the "R" on the ballot, and they resolve that psychic tension by following their leaders. Sigh.

Jon Walker's report notes that fiscally, the numbers add up in Susan Wismer's favor:

Susan Wismer, the Democratic candidate for governor, said the state is leaving a fortune on the table by dragging its feet on expansion. Wismer, a state legislator from Britton, argued in a debate in August that South Dakota hospitals are losing more than $250 million a year from federal money that would flow into the health care system if Medicaid were expanded here. Daugaard said in the same debate that expansion would be a new $95 million burden on the state budget from 2017 to 2020 [Jon Walker, "Poll: More S.D. Voters Back Medicaid Expansion," that Sioux Falls paper, 2014.10.25].

Notice that even reaching out for four years of budget impact doesn't come close to beating one year of the fiscal boost South Dakota would get from Medicaid expansion. Let Governor Daugaard have all the "No more free stuff for poor people!" voters quoted in Walker's report (one from her lofty perch at Dakota Dunes). Even the modest support shown in the Mason-Dixon poll is one more bit of evidence that South Dakotans would elect Democrats if they integrated their policy thinking into their voting.

Related Reading:

  1. The lagging Republican Senate candidate in North Carolina is U-turning his position to welcome the Medicaid expansion.
  2. The only problem with Nevada's expansion is a doctor shortage and a high percentage of already scarce doctors refusing to see Medicaid patients (because, you know, health is for the rich, kind of like how I should only teach kids whose families are big tippers).
  3. Republican Ohio Governor John Kasich still wants to repeal the Affordable Care Act, but not the Medicaid expansion. Kasich told AP the opposition to Medicaid expansion in the Ohio statehouse "was really either political or ideological.... I don’t think that holds water against real flesh and blood, and real improvements in people’s lives."
  4. In nine states that have expanded Medicaid under the ACA and where Democratic governors face strong Republican challengers, none of those GOP challengers have advocated repeal of the ACA's Medicaid expansion.