Flawed Medicaid Proposal

May 2018

Oppose South Dakota’s proposal to take Medicaid away from people who do not meet new work requirements

South Dakota is proposing to take away Medicaid from parents in Minnehaha and Pennington counties who don’t meet new work requirements. Parents of very young children, even as young as one year old, are the sole targets of this proposal. The state cannot move forward with its proposal without federal permission (called a “waiver”), or without hearing from everyday South Dakotans.

We need your help to make sure Medicaid officials hear loud and clear that taking away Medicaid would make it harder for parents to stay healthy and be able to take care of their children.

Submit your comments by June 19, 2018, on why the South Dakota’s proposal to take away Medicaid from parents who don’t meet new work requirements should be rejected. Then take 5 minutes to fill out this survey to give a snapshot of how this will impact you and your community.

You might think about these:

1) South Dakota’s proposal will hurt families and children. Parents of children age 12 months thru 5 years and with incomes below about half the poverty line are at risk of having their health insurance taken away if they can’t work enough hours each month. Losing coverage won’t just affect parents– it will also harm their children. When parents lack insurance, children are less likely to have regular doctor visits, more likely to become uninsured themselves, and more likely to experience financial insecurity. With this proposal, South Dakota is turning its back on a proud history of supporting children’s health.

“As a single parent my schedule was often unpredictable. If my child got sick, I missed a shift and didn’t get paid for those hours ... it became impossible to raise my son and earn a living wage ...” -Tina Keys

2) The proposal creates a no-win situation: If people try to keep their coverage by meeting the work requirement, they may lose coverage because their incomes would exceed South Dakota’s very low income limits. It makes no sense to make people work to keep health coverage, only to take it away when they do.

Some in the program will be cut off Medicaid as they work more hours and income exceeds the limit. They’ll get temporary help, but after that, unless a parent’s job has benefits or income enough to qualify for subsidized insurance, that parent would have no coverage at all. Then costs for those individuals’ catastrophic illnesses (that could possibly have been prevented) go to South Dakota citizens.

3) There are more ways people, including people with disabilities and working parents, will lose health coverage.

• Red tape. Documenting work-related activities makes it harder for everyone, especially people with physical disabilities or mental health needs, to stay covered, even if they’re already working or if they qualify for exemptions.

Inconsistent job hours. Some people could average over 80 hours a month over a year, but fall short in one or more months -

for example, because their employer won’t give them enough hours of work – and lose health care.

4) Native Americans will be disproportionately hurt by South Dakota’s proposal. That’s because Native Americans have very high levels of unemployment. Many also have significant health needs that make it especially dangerous to go without coverage.

5) This flawed proposal undermines the health promise of Medicaid and its core purpose. There are better incentives to connect people to work.

A better way: South Dakota should help with services - like health services, education opportunities, quality job training, child care - for anyone who needs help to find steady work, without taking away anyone’s health coverage.

6) This proposal is opposed by healthcare providers and advocates, including:

  • American Academy of Family Physicians

  • American Academy of Pediatrics

  • American Heart Association

  • Arthritis Foundation

  • Cystic Fibrosis Foundation

  • Leukemia and Lymphoma Society

  • National Multiple Sclerosis Society

  • National Alliance to End Homelessness

  • March of Dimes

  • American Diabetes Association

7) Learn more about the proposed changes to Medicaid and what we've learned from similar programs operating in other states.

Send comments by Tuesday, June 19, 2018.

Email to dss.medicaid@state.sd.us (Subject line: “career connector public comment”)

Or write to: Division of Medical Services, DSS, 700 Governors Dr, Pierre SD 57501.

(If you don’t mind, also send a copy to us: breadsd@gmail.com)