With the passage of Amendment D, South Dakota became the 39th state to expand Medicaid. Medicaid is the leading public health insurance program for people with disabilities and low incomes in the US. The Expansion is expected to extend affordable healthcare to over 40,000 adults in SD. Many of these recipients are employed in jobs without healthcare coverage. Expanded coverage is expected to begin by July 1, 2023.
Expanding Medicaid was an original tenant of the 2010 Affordable Care Act; however, in 2012 the Supreme Court ruled that the federal government could not force states to expand their Medicaid programs. At that time SD, along with several other states, opted out of the expansion program. However, the benefits of expanding Medicaid have been shown and 38 states plus Washington DC have adopted Medicaid Expansion. From 2013 through 2019, the state share of Medicaid costs rose 19.5% in states that expanded Medicaid, versus a 26.4% increase in states that opted out of the expansion program. Those states electing to expand Medicaid were able to cover more persons and experience modest state-fund Medicaid cost increases in the process, relative to the non-Expansion states. More than nine million persons who would otherwise be uninsured have health coverage under the Expansion. Personal bankruptcies have decreased across Expansion and non-Expansion states since 2013, with this reduction being particularly sharp across the Expansion states. Hospitals in Expansion states have experienced considerable revenue increases that appear to be attributable to Medicaid Expansion.
Amendment D included deadlines for implementation. The Department of Social Services must submit its Medicaid expansion plan to the federal government by March 1, 2023 and begin providing benefits to newly eligible people by July 1, 2023. Information regarding the enrollment process will be available as these deadlines near.