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Lowe Supports Medicaid Expansion

Last updated on 2014.06.18

Gubernatorial candidate Joe Lowe is on the same page as South Dakota doctors and Democrats (and at least one Republican!) in supporting the Affordable Care Act's Medicaid expansion:

Are we really going to leave 48,000 without Medicaid?

I question why our Governor will not invest $1.5 million in state funds to receive $214 million in federal dollars for the Medicaid program. He states it is because he does not trust the promises of the federal government in future years to come [Joe Lowe, letter to the editor, 2013.12.17].

In his December 3 budget address, Governor Dennis Daugaard deemed other elements of the ACA too "unpredictable and chaotic" to permit investing in the Medicaid expansion, which the federal government will ultimately bankroll in a 90-10 cost share after 2016. In the same speech, Daugaard promises to continue regular Medicaid funding, for which the unpredictable and chaotic federal government offers only a 52-48 cost share.

Lowe wonders how Daugaard's logic allows him to accept any of the federal funding on which South Dakota depends:

If the Governor does not trust the promises of the federal government then our state has much to worry about. This state is a beneficiary state when it comes to federal tax dollars. Our state residents pay less in federal taxes than the federal government spends in our state. In Fiscal Year 2011 we received almost $2 billion in federal government contributions, this accounted for nearly half of all state budgeted spending. So the excuse that he does not trust the promises of the federal government is very disturbing to me. He would be shutting down most state government programs based on that assumption. It appears he just does not want to support those needing Medicaid [Lowe, 2013.12.17].

Governor Daugaard's FY 2015 budget proposal counts on Uncle Sam to contribute 40% of the total state government budget.

Not supporting a Medicaid expansion will cost all of us money. In a survey released by The American College of Emergency Physicians, it was reveled that the uninsured patients treated in the ER tend to be sicker and have more serious medical conditions than patients who have insurance. A majority of those surveyed (74%) say that uninsured patients are more likely to die prematurely and overwhelming number of physicians (94%) agree that arranging follow-up care is more difficult in those patients without insurance. Also federal law mandates that when these uninsured individuals show up in the ER, they cannot be denied access to care. The costs of their care is eventually shared with the county directly (our community), and other insurance companies indirectly, through increased health care for those with insurance. Our Community hospitals also bear the brunt of having to treat uninsured patients in the Emergency Room. They will sustain losses by having to treat those without any health insurance [Lowe, 2013.12.17].

Senator Stanford Adelstein and others have pointed out that we are already paying the hidden tax of uncompensated medical costs for folks not currently covered by Medicaid or private insurance. Taking advantage of federal funding for the Medicaid expansion for however long it may last would be no financial loss for South Dakota; it might even save us money.

It is time to support the Medicaid expansion and help the 48,000 fellow South Dakotans that needs Medicaid. Call this governor and your legislators and tell them to support the expansion of Medicaid. It is about our people not fabricating excuses [Lowe, 2013.12.17].

We don't have to wait for Lowe to become governor to do the right thing and expand Medicaid. But if we can't talk sense into Governor Daugaard, and if we can't sway a veto-proof majority of the Legislature to make a sensible and moral policy choice, we voters will have a chance to expand Medicaid by electing Joe Lowe governor next November.


  1. Jerry 2013.12.22

    Bravo Joe Lowe, you have nailed it sir! The very idea that we citizens of South Dakota can sit idly by and allow those that need health coverage to be denied is a real tragedy. These are our neighbors and our family and we allow this kind of shameful antics to blight our people in need. Dennis should be impeached for dereliction of duty, but the closest we have to do that now is to vote him and his crooked cronies out. We have plenty of money to toss around for out of state interests or the interests of political allies. We also seem to have plenty of money to give pay outs to silence people involved in investment schemes involving EB-5 scams. Denny and crew are heartless as well as dishonest. Look around, take a look at your fellow citizens here. We are speaking of folks that work every day. They work for company's that do not provide any kind of health insurance. These are the kinds of jobs where you are just putting the food on the table for yourself and your kids. Yes, the children qualify for Medicaid, but not their parents, what kind of system is that? You see them each and every day. Ask yourselves, what would happen if something changed in your own circumstances and your job or livelihood would disappear. What would happen to you if your income was such that it did not qualify for any assistance to protect you? Would you still be so glib as to support this band of cutthroats in Pierre that care only for themselves? Those jobs that they do are necessary for the economic engine of our state. We should have no place for that kind of hate the working poor politics in South Dakota.

  2. Douglas Wiken 2013.12.22

    Perhaps Daugaard is aware of some coming GOP hi-jinks to obstruct government and wants to hang that on Obama before the obstruction hits the fan.

  3. grudznick 2013.12.22

    What will be Mr. Lowe's Logo and Slogo during this next election?

    Go Lowe
    No Ordinary Joe
    I've got a fire hat and Dennis doesn't

    I, for one, hope he poses wearing a fireman coat all the time like young Dr. Bos wears her white doctor coat.

  4. interested party 2013.12.22

    Pierre is experiencing yet another infrastructure failure today. DD is a unitary executive rendered impotent by his party's inability to do anything but react to problems.

    Fire him and flush the GOP from Pierre.

  5. chris 2013.12.22

    Daugaard's law degree was a waste. He should have studied elementary math.

  6. grudznick 2013.12.22

    Larry Goes Joe!

  7. Roger Cornelius 2013.12.22

    Interesting that Daugaard does not trust the federal government and fears that the Medicaid expansion is too chaotic and unpredictable.

    Sadly, Daugaard doesn't share those same sentiments about the EB-5 Visa investment program. This state has never seen the financial corruption at the level that exist with that program. The Governor and Rounds have acted chaotically and unpredictable in the management of investor dollars and state tax dollars.

  8. grudznick 2013.12.22

    Shut down both of those nasty federal programs, I say.

  9. Roger Cornelius 2013.12.22


    In cased you missed it, the Medicaid Expansion program hasn't been implemented by Daugaard. Pretty difficult to shut something down that doesn't exist!

  10. grudznick 2013.12.22

    Obama needs to shut down both of those nasty federal programs, I say.

  11. Jerry 2013.12.22

    Grudz just likes to keep the poor folk down. That way it gives him a feeling of superiority when he looks in that vacant mirror.

  12. grudznick 2013.12.22

    Mr. Jerry, I am poorer than most but want to help others, nay admonish others with a waggling finger, to help themselves. Stop relying on handouts, peoples.

  13. Roger Cornelius 2013.12.22

    grudz, are you will to tell farmers, ranchers, corporations that get tax breaks, big oil, grandma and grandpa that are on Medicare, Social Security, poor people that need food stamps, and all the other socialistic programs, "to stop relying on handouts".

    grudz wants Obama to shutdown both those nasty programs, but South Dakota Republicans love begging and getting money from Communist Red China. Nasty Republicans!

  14. grudznick 2013.12.22

    Social Security is something paid into and not handed out. As to the rest of those bastardized programs, indeed. Shut them down. Especially the farmer and rancher welfares. Those people are richer than rich.

  15. grudznick 2013.12.22

    Look at Mrs. S. She's never had to work a day in her life.

  16. Roger Cornelius 2013.12.22

    grudz, I'm aware that Social Security is an "entitlement" program that people pay into.

    Tea party type like to call it a socialistic program or a ponzi scheme.

  17. Roger Cornelius 2013.12.22


    I left a comment for you on the "Frankenfeld Calls Rounds a Control Freak

  18. grudznick 2013.12.22


    You left a comment for me here as well, and I thank you for it for it is easier to find. I hope you and yours get many cans of cranberries and juicy turkeys this holiday season, but please don't go caroling at old people's houses because we really don't like it much.

  19. Roger Cornelius 2013.12.22


    Is it politically correct for me to Wish You a Merry Christmas, hope so, wouldn't want O'Reilly on my case.

    As to the cranberries, I make my own from fresh berries and will be enjoying a nice prime rib.

    I promise not to go caroling, my family says I can't even hum in tune!

  20. grudznick 2013.12.22

    I certainly acknowledge the tradition of the Merry Christmas wishing, and I will wish it back to you. I even help give Santa gifts to small children when I can. I also hand out candy on Halloween and once pretended to be a tooth fairie. So thank you for the wishes. I hope you and your family are very well this season, sir.

  21. Rorschach 2013.12.22

    $214 million in new money coming to SD would do more for the state than anything GOED and the governor are able to do by doling out corporate welfare, giving tax breaks to Canadian companies, and paying a out-of-state company millions to recruit out-of-state workers. A Medicaid expansion will put a lot of money into the SD economy to circulate over and over creating real jobs even as real South Dakotans gain access to quality medical care. Anybody who turns down this much investment coming to SD isn't interested in economic development. State government has paid a lot more to get a lot less But as long as the electorate continues to reward bad decision making it will continue to happen.

  22. barry freed 2013.12.23

    The first statement he made was a judgementally indignant: "We already take care of those who are not able bodied, the women, children, and truly disabled".
    He came up with the tea party courting line of not trusting Washington later, probably after a personal injury attorney in the State House advised him, the implications of what he had said.
    When the focus is on the utterly stupid business decision of turning down $214 for $1.60, we are giving him a pass in the media.
    That "able bodied" statement reveals a truth greater than frugality, it is a personal, moral decision by someone who is in a public position SWORN to serve ALL; able bodied or not.
    That personal position is outside of his powers as Governor and is Actionable, as supported by the millions he, the Lawmakers, Congressmen, and local media EARN by backing the big Healthcare agenda with lies and half-truths (same as a lie in MY South Dakota).
    48,000 potential South Dakota plaintiffs, is there a Personal Injury lawyer on the Blog? January 1 is just around the corner, who will be the first South Dakotan to die under Daugarrd's personal decision?

  23. Les 2013.12.23

    Who pays the 200+Mil in a couple of years when the fed backs out? Another cut in education?

  24. caheidelberger Post author | 2013.12.23

    Nobody, Les. If the feds back out, we back out... although we can make the argument that we're already paying that cost through uncompensated care, and we would go back to paying that cost if the Medicaid expansion ended.

  25. Jerry 2013.12.23

    I thought that you were a serious commentator Les, come on man. The Federal government (all of us) will pay the 10% of the costs needed after 3 years of full funding. This could all be eliminated completely with a simple raising of wages to a living standard. Not only would it take people out of Medicaid, it would stimulate the main street economy. The people get medical and economic security and so does main street.

    By putting more tax dollars into the local economies, it would increase the dollars needed to better fund education. The world goes round and round and we smile with relief. Problem solved.

  26. barry freed 2013.12.23

    Les asked: Who pays?
    Not us, we can walk away after 3 years owing nothing, with no strings attached.
    The healthcare industry knows we won't want to give it up once we have it. Then we will start telling them an MRI 50 times more expensive than in another country is unacceptable. So, they fight viciously.

  27. interested party 2013.12.23

    Jerry, Mr. Freed: no doubt you have learned the folly of responding to the ridiculous.

  28. barry freed 2013.12.23

    On the bottom side of the scale, just above minimum wage, a person pays through the Exchange 2% of their net income. Most working poor of South Dakota would find a way to pay that if they could, but silly Obama and Congress thought the working poor should be using that little bit of money to supply themselves with food and shelter, hence the 138% over poverty Medicaid Plan.

  29. Nick Nemec 2013.12.23

    Les, we've all heard the old adage there are no stupid questions, its a lie. I knew an old Marine Corps gunnery sergeant who when asked a ridiculously stupid question by a young Marine known for asking stupid questions replied "If a bullfrog had wings he wouldn't bump his ass." It's as good an answer to your question as any other answer given.

  30. barry freed 2013.12.23

    Interested Party:
    Yes, I have posted in the RC Journal, but it's practically all we have. I have been composing a letter to Warren Buffet, owner, begging for Journalism in the Journal.

  31. interested party 2013.12.23

    Please call me Larry, Mr. Freed.

  32. barry freed 2013.12.23

    I assume Les is sincere and cares about his State.
    When the RC Journal prints yet another AP story with a: "OBAMACARE FAILS!" Headline, followed with 15+ PARAGRAPHS about the glitches in Minnesota's MnCares Exchange Website, and 3 SENTENCES of how they have the LOWEST Insurance Rates in the US and have 48,000 working poor enrolled already (that number sounds familiar), we can't fault people for lacking the information they need. There is probably zero notation of the "3 years free" in any Journal Article.
    I know the Journal is in bankruptcy fighting for its existence, but maybe presenting more than one side of issues, such as printing side by side, counterpoints to Kristi Noem's and John Thune's pathetic OpED's on the ACA, would increase their subscription numbers by having something interesting to read.

  33. Jerry 2013.12.23

    Barry, one praise, your take on the medical field. The insurance companies that raised the rates higher than a giraffes behind, say that the reason is not Obamacare, but the morally obscene rising costs of healthcare. I agree with that. The medical profession is gouging and we all know that.

    One not so praise, your take on blaming Obama for the poverty level decisions. If you do not know, here I am to tell you. This form of the ACA is a republican idea that goes back to at least 1993 and was presented by Newt and Dole along with the Heritage Foundation. This is supply side, private thievery by the healthcare industry. Granted, most thinking people want to have Medicare for all, but this is all that we could get in the Washington climate of that time. Think of how even our own Stephanie voted against healthcare reform. This is working for most, but not for all and for that, we need to put the pressure on to make this happen in our state with Medicaid expansion. Tell the politicos like Denny and all of his minions that this is wrong. We should go to their churches at this time of the year and call them out for being so dishonest and hateful towards our working poor and ask them if The Baby Jesus would approve of their message.

  34. Rorschach 2013.12.23

    Gov. Daugaard is just sending a message to Big Medical that he needs more campaign contributions before he's convinced. He didn't slam the door tightly shut on it, which means he'll come around on it (reluctantly) since it's an election year after having convinced everyone of his conservative doggedness. It's predictable posturing.

  35. Les 2013.12.23

    Every once in a while there is the perfect opportunity to throw a bit of flounder to the Maddville pond. The feeding frenzy of journalism Barry Freed is begging for, is so predictably entertaining, particularly with the Christmas Spirit so effervescently flowing. Marry Christmas back at you all!

  36. lesliengland 2013.12.23

    joe, let's go! we need to be proactive rather than waiting for the election to get around to resolving this Medicaid issue under obamacare.

  37. ron wieczorek 2013.12.23


  38. Jerry 2013.12.23

    Certainly correct on the spelling end of that Mr. Wiezorek.

  39. Jerry 2013.12.23

    At this effervescently (need alka-selzer) flowing holiday season, I think of the immortal words of Larry "Jerry, Mr. Freed: no doubt you have learned the folly of responding to the ridiculous." But I go further and throw caution to the wind.

  40. Jerry 2013.12.23

    More good stuff from the ACA. "Affordable Care Act provisions have a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010-2012 period, and this trend has continued into 2013. Projections by both the Office of the Actuary at CMS and the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth. "

    Saving money and protecting the lives and welfare of our citizens, oh my. Here is the whole report

  41. grudznick 2013.12.23

    Don't throw butts from cars.
    Dunce will eek media time.
    Go Joe Lowe. Firehats.

  42. caheidelberger Post author | 2013.12.24

    Ron, my side has a solution. Expand Medicaid. Help sick people. Reduce uncompensated costs for hospitals. The link you provide looks like the exercise in feckless rhetoric. "The Star Lore of Homer and the Galactic State of Mind" won't pay for medicine any faster than prayer. What's your policy solution?

  43. ron wieczorek 2013.12.25

    The health care crisis is just one of the symptoms of a collapsed financial system. Returning to the principals of the American Political-Economic System as stated in the Constitution[Natural Law] and the preamble to the Bible[Genesis 1 26-28] is essential to saving the nation. declaring health care with out the system to make it happen is fruitless. The Constitution expresses the principle of the right to life, which means-Universal Health Care.
    The chief concern at present is the re-establishment of public credit as a source of investment, and to replace our currently failing monetary system with a system of legitimate economic practice. To hell with speculation, usury and gambling[Wall Street] as the basis of our economy. The British System of free trade has always been the enemy of American Republic.
    In abandoning our original Constitutional system of public financing and credit, in favor of monetary gain and deregulation, the "new money economy" was maintainable only for a certain period of time as the physical wealth, created under the direction of our original Constitutional credit system, was worn out and liquidated as a process of physical attrition. This "new money economy" operates directly in opposition to our original Constitutional credit system, which operates according to a future state which the present is striving to create.
    The ignorance of the populace respecting both the history and the nature of the credit system, as it was used by Franklin, Hamilton, Lincoln, Roosevelt, and Kennedy, combined with the backward education and propaganda campaigns (funded mostly by Wall Street), has always been the cause for these periods in which Wall Street and foreign or corporate interests take over the United States -- periods which must be broken away from with a reassertion of the credit system and the investment in great projects, as it was under those administrations just mentioned.
    Steps that must be taken to re-establish the American System of Credit, and to begin the reconstruction of our economy with NAWAPA XXI. Without this direction, we have no credibility to build an economy on which anyone can depend.Save the Nation, re-enact Glass-Steagall, create the Third National Bank and create the credit to build infrastructure for a future. At this point NOTHING LESS WILL SAVE THE NATION.

  44. caheidelberger Post author | 2013.12.26

    I was afraid something like that was coming. Even if there are bigger dragons to slay, the immediate fact is that expanding Medicaid will do South Dakotans good.

    (Now do I dare ask where the Constitution says anything about a credit system?)

  45. grudznick 2013.12.26

    Mr. Wieczorek, that sounds almost Larooshish.

  46. ron wieczorek 2013.12.26

    It is. Is that a problem? Is it true or false, should be the question.

  47. dave bowen 2013.12.30

    there is only one word for the Republican refusal to expand medicaid,with money they do not even have to spend,and is not theirs. MEAN!!! They whine about cost to taxpayers,but ignore the fact that it is still cheaper than the emergency room.

Comments are closed.