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Killer Proposes Medicaid Expansion and Insurance Exchange for SD Reservations

Rep. Kevin Killer is fighting for re-election in District 27. He's leading the mighty get-out-the-vote charge on the Pine Ridge Reservation that could tip the balance in the U.S. Senate race.

And on top of that, he's proposing a big tribal sovereignty idea: let South Dakota's tribes leapfrog the state and set up their own health insurance exchange and expansion!

“If I am re-elected I plan on introducing a bill that would ask the state to delegate their authority to tribes on the reservation under the Affordable Care Act and allow for tribes to set up their own healthcare exchanges and to expand Medicaid to tribal citizens,” said Killer.

...“If the state of South Dakota wants to opt out of certain parts of the Affordable Care Act based of principle that is their right. What I want to do is to allow for tribes to partner with each other to set up these exchanges to help with economic development and to provide coverage to their members,” said Killer [Brandon Ecoffey, "Indian Lawmaker Kevin Killer Makes Big Plans,", 2014.10.27].

But what about the Indian Health Service? Ecoffey explains that Congress has hamstrung the IHS and Bureau of Indian Affairs budgets, leaving tribes reaching for alternatives. Medicaid and private insurance revenue can keep IHS facilities running. Plus, IHS doesn't cover everything that Medicaid and private insurance do. Let the tribes extend those benefits, and tribal members get access to better health care.

But would our ACA-averse Republican Legislature let the tribes exercise their sovereignty to take advantage of federal services that the SDGOP has denied the rest of South Dakota?

It sounds like a heck of an idea, Rep. Killer! I look forward to your testing your colleagues' commitment to tribal sovereignty and health care this winter.


  1. larry kurtz 2014.11.04

    Tribal nations are the 51st State: now let's annex Mexico.

  2. Roger Cornelius 2014.11.04

    It is my opinion that Mr. Killer does not have to ask the state's permission, the tribes can go directly to Washington and exert their sovereignty.

  3. jerry 2014.11.04

    Larry, we have already annexed Mexico. Take a look around and you will see who makes your beds at your hotel stay, picks the fruit for your table, cuts the forests for the products, takes care of the children while you work at shitty jobs that pay you just enough to pay them and who is cleaning the dishes where you eat. I can tell you where they came from and I can tell you how is it is they can work without proper credentials, real simple, they have been annexed into our system. The last thing our system needs is to get rid of them and move them back to the annexed state. We would fall on our collective behinds so fast, it would make you laugh out loud. Kind of like when someone takes a header on the ice, only in this case, you would not wait to see if they were hurt or not to bust a gut laughing.

  4. larry kurtz 2014.11.04

    Jerry, it blows my mind to see the sprawl in Rapid City built by uninsured alien workers. A map showing which counties benefited from ObamaCare came across my twitter feed a couple of days ago but i have lost it: Indian Country pretty much got insured.

  5. jerry 2014.11.04

    I see the turtle won in Kentucky and I am sure we will be seeing the same thing all over the place. It did not help that these losers ran from the president who has done so much for the country. The economy, for goodness sake, the economy was not even brought up. The ACA, nothing about it other than repeal it. Watch what happens after tomorrow, not a damn thing. It will still be with us so no worries there. What warms my heart is that finally, at long last, there is some better coverage of Native people on the reservations both in the boundary and state wide.
    Now, to make things even better, there may be a change with some better folks coming in to tribal government in Pine Ridge. Lets hope for that and to have good people like Mr. Killer come with the good ideas about the expansion of Medicaid for tribal members, that will be exciting for sure!

  6. caheidelberger Post author | 2014.11.04

    Jerry, memories are short. They need more reminders from Democrats who aren't letting Republicans define the narrative. When we run scared from our President, our successes, and our identity, we lose. Rep. Killer is having the guts to embrace ACA and challenge Pierre to keep denying its people the benefits of good policy.

  7. Charlie Hoffman 2014.11.04

    cory; should we also put into place international borders around Tribal Land?

  8. Les 2014.11.04

    To give credit where credit is due, I think it was Mort who said something like, " out here in West River, we are bordered by four states and three foreign nations, Charlie. We all want our independence until we don't.

  9. caheidelberger Post author | 2014.11.04

    I don't know if international borders are necessary, Charlie... but what does sovereignty mean, anyway?

    And do we even need to have that discussion to let the tribes take advantage of the ACA?

  10. Roger Cornelius 2014.11.04

    It is no "should we also put borders into place borders around Tribal Land". That is not a decision for the state or federal government to make, tribes have that right.

    It is pure fantasy to have a discussion about reservation borders, we already have them.

    Unlike South Dakota Republicans, off reservation businesses enjoy a cordial business relationship with their neighbors.

  11. Roger Elgersma 2014.11.05

    Kevin can think. More democrats should be that good.

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