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Lowe: Medicaid Expansion Saves Counties Money on Indigent Care

Jumping to the gubernatorial contest, Democratic candidate Joe Lowe endorses one very specific policy: expand Medicaid!

A former mayor of Mission Viejo, a community of 100,000 people in southern California, Lowe is critical of the current administration’s failure to expand Medicaid, calling it “unconscionable.”

It leaves 48,000 South Dakotans without health insurance, and puts a $4 million annual burden on counties for paying indigent medical bills, he said.

Expanding Medicaid would have cost the state $1.5 million, but it would have received $274 million from the federal government over three years, he said at the Beadle County Democratic Forum on Thursday [Roger Larsen, "Lowe Would Push for Expanding Medicaid and Better Teacher Pay," Huron Plainsman, 2014.04.07].

Did you catch that part about indigent care at the county level? According to a December 14, 2013, Mitchell Daily Republic report, South Dakota's counties spent $3.3 million in the preceding year (I'm guessing FY 2013?) on caring for folks too poor to cover their medical bills (the kind of people Mike Rounds says we should not help). MDR says $2.5 million of that might have been covered by the ACA Medicaid expansion that Lowe advocates. Lowe says the Medicaid expansion would cost South Dakota $1.5 million.

Spend $1.5 million, save counties $2.5 million. Right there, without any other fiscal analysis, Medicaid expansion makes sense. It reduces the tax burden on South Dakotans by $1 million.

Why would Republicans deny counties this modest but useful bit of tax relief? They will claim that we can't count on the big federal money backing the Medicaid expansion to continue, but find me one county commissioner who will say, "Well, heck, if there's a chance we aren't going to be able to save a million bucks five years from now, there's no sense in our saving a million bucks this year."

Lowe recognizes the absurdity of that fiscal position:

Gov. Dennis Daugaard has said he doesn’t trust the promises of the federal government.

“Well then, surrender the flag, shut down the state,” Lowe said. “Over half of the state’s spendable budget is federal dollars” [Larsen, 2014.04.07].

Lowe rightly notes that expanding Medicaid is immediate tax relief for counties. Why South Dakota would leave that money on the table and burden local taxpayers with higher-than-necessary taxes is beyond me.


  1. larry kurtz 2014.04.07

    DD's stance on Medicaid expansion is motivated by a culture of racism and we all know it.

  2. mike from iowa 2014.04.07

    Wingnut party is full of sick puppies. Feed the koch bros,starve the rest. Just like jesus would do.

  3. tara volesky 2014.04.07

    I disagree Larry, it's motivated by big $$$$$$$$$$ corporate health and insurance companies. Look who is bankrolling him.

  4. larry kurtz 2014.04.07

    That DD can just blow off $412 million in federal money to protect his cronies' racism is SDGOP business as usual.

  5. Jeff Barth 2014.04.07

    Medical bills cost Minnehaha county hundreds of thousands a year. Then we have staff and attorneys who work to adjust those bills. Then we pay the rent for folks impoverished by medical bills. Then we feed them (schools feed the kids). When they die we pay for their funerals.
    Joe Lowe is right. Medicaid expansion would save every South Dakotan on their county property taxes and might just save their lives too!
    Go Joe!

  6. mike from iowa 2014.04.08

    Life in the balance- Do we choose the possibility of having to raise taxes in the future or do we choose the possibility of saving lives today? Tough choice,but I'm going with keeping taxes low for the wealthy.

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