There’s good news and bad news.

The good news is that the federal government is offering South Dakota $280 million annually to benefit hospitals and clinics throughout the state if our Legislature will vote to expand Medicaid.

The condition is that our state contribute $1 for each $15 in federal dollars received. Any financial advisor will tell you it’s crazy to pass up such an excellent investment option. You can call that $1 a tax or an investment, but by any name it benefits every community in the state. These dollars pay hospitals and clinics and immediately are spent in grocery stores, hardware stores, dealerships, every business up and down Main Street, benefiting the whole community. Plus, strengthening two of the well-paying groups in each city and town, hospitals and clinics.

Now the bad news. Our Llegislature has voted year after year to refuse Medicaid expansion, thereby missing out on those millions of dollars, thereby weakening our healthcare institutions and by extension, whole communities across the state. That $1 must be too high a price to pay for the $15 being offered.

Republican and Democrat administrations alike are urging us to expand Medicaid. And looking around we see North Dakota, Minnesota, Iowa and Nebraska all with Medicaid expansion, all benefiting from those federal dollars designed to strengthen their healthcare facilities and by extension whole communities. Three Republican states, all in our neighborhood, all with Medicaid expansion. And here we sit, being left out, watching our healthcare systems, especially in smaller communities, inching backward and many closing their doors. Bad news indeed. This does not have to be.

Contact your elected officials, state and federal, urging them to vote to expand Medicaid for the benefit of us all.

(6) comments


I think perhaps we need to research Medicaid. It is only for those who are ELIGIBLE for it under Federal and State regulations. If we do not have eligible disabled, elderly, etc who are not ALREADY covered, that expansion largesse is of no use to South Dakota and the $15/1 is not a "good deal." SD, if they accept the deal will be in debt to the Govt instead of the other way around.... UNLESS there is a caveat that I am unaware of, the increase in Medicaid is not to increase what the current recipients already receive. If there is, you are correct and there would be no reason to turn it down. It may well have other regulations that need to be met that would cost the state far more than it would help monetarily. I think you need to talk to someone who is opposed to the deal to find out exactly why. There has to be a reason for the No vote. I am looking and I hope you will as well.


There’s a very good reason to vote “NO.”

It’s simply because medicaid expansion was the result of policies put in place by the hated Obama administration.

Don’t hold your breath looking for any better explanation than this, Kate.


Kate - Google “who is covered by expanded Medicaid”. The whole point of Medicaid expansion is to cover those who have no coverage, don’t qualify qualify for Medicare or an ACA subsidized policy AND who earn less than 138% of the poverty guideline.

Most who would get the coverage would be childless adults. I don’t have the South Dakota number, but nationally, if every state expanded coverage, about 4 million people would be added.

FYI every state, including South Dakota, gives immigrants one year of automatic coverage. New immigrants are not part of the 4 million noted above.

So why doesn’t South Dakota expand? I like to think they drink too much while in Pierre. But note that Nebraska ONLY has expansion because it was a voter initiated ballot measure. A ballot is circulating here as you read this. Our legislature is doing its it’s best to block the ballot measure. Shame on them.


This is the deadly siren call of socialism. This is why Republican Patriots are doing their best to pass laws to prevent you communists from ever stealing another election.

Where We Go One We Go All!


your comments are lacking in facts. Conservatives are ok with giving corporations millions in tax incentives and subsidies. However, making sure that the people that are the backbone of this nation have good health care is socialism. What a double standard. Please quit using "socialism" to scare people it's getting old. Find a new argument or you please do the nation a favor and go away!

Old Hugh

I’ve been borrowing the words of contributors on this feed who are better educated than me, and express my sentiments better than I can. So here goes again:

Elsewhere Mr. T wrote words that directly apply to the selfish refusal of our politicians to provide access to the medical care they surely enjoy for themselves and their loved ones. Mr. T’s comments bear repeating. He wrote:

“Despite having the most expensive health care system in the world ($7,290 per capita annually), we rank last in services delivered compared with six other industrialized countries - Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom.

And this is why Americans' life expectancy lags well behind Japan, Switzerland, Australia, France, Sweden, Canada, Netherlands, Austria, Belgium, United Kingdom, and Germany.

In this regard we truly are an “exceptional” nation. This should shame us all. If we cared, we could do better.”

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