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South Dakota considers adding work requirement to Medicaid expansion

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Mike Moen

(Greater Dakota News Service) South Dakota is poised to launch a Medicaid expansion this summer, after voters approved the idea last fall, but there is a legislative push to add a wrinkle to the eligibility process.

A Senate committee is expected to ramp up debate on a plan to ask voters in 2024 whether the expanded Medicaid program should include a work requirement. The resolution has already cleared the House, and said the requirement would apply to "able-bodied" recipients.

Sandy Frentz, retired public health manager for the City of Sioux Falls and former co-chair of the American Heart Association Medicaid Expansion Cabinet, said it is the wrong thing to do, given the promise of helping uninsured South Dakotans, and would create too many headaches for certain situations. 

"What if we have somebody who's eligible that is working that ends up with a catastrophic health diagnosis and is unable to work?" Frentz asked.

She pointed out it creates burdens for administrators, especially if the state has to argue over the scope of the term "able-bodied." Sponsors of the plan contended it is about incentivizing people to work, and said they simply want to ask voters how they feel about the idea. 

Tony Burke, state government relations director for the American Heart Association of South Dakota, argued voters already expressed their opinion.

"They wanted this to be implemented, they want it to be implemented swiftly, in its current way, shape and form," Burke asserted.

For any lawmaker concerned about fraud, he noted the state's program is nationally recognized in the area of prevention.

A Department of Social Services report noted South Dakota is one of a handful of states exempt from certain audits due to the low prevalence of provider fraud.

Under the Affordable Care Act, the federal government covers most Medicaid expansion costs for states.