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Tribal Health Expert Discusses Medicaid Expansion in SD

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Thursday, November 3, 2022   

In less than a week, South Dakota will learn whether voters support expanding Medicaid, where a researcher said approval would especially help tribal communities.

For months, a range of organizations have pledged support for this fall's ballot initiative, including AARP South Dakota, touting the benefits of providing coverage for the state's uninsured.

Karla Abbott, associate professor of nursing at Augustana University and an enrolled member of the Cheyenne River Sioux Tribe, said another federal program, Indian Health Service, is poorly funded and leaves too many gaps for tribes.

"Maybe it involves a transfer to a hospital here in Sioux Falls, for instance," Abbott explained. "But tribal people don't have the money to actually pay the bill, so they're not going to follow up with that care."

She stressed expanding Medicaid would help with care not covered by the Indian Health Service. South Dakota is among the dozen states yet to expand Medicaid since incentives were offered under the Affordable Care Act. Opponents, mainly Republican policymakers, cited cost concerns, although the federal government covers 90% of the cost.

Just like the rest of South Dakota's population, Abbott argued expanding Medicaid would create a much healthier workforce, boosting the state's economic hopes.

"Reservations are in remote areas, just like rural South Dakota has remote areas off the reservation," Abbott pointed out. "When you're working and looking for employees to fit a particular job description, you don't have a huge pool to choose from."

She added when you do locate someone who is qualified and willing to do the work within these communities, it is important they are healthy enough to stay on the job. It is estimated approval and implementation of Amendment D would expand Medicaid eligibility for more than 42,000 South Dakotans.

Disclosure: AARP South Dakota contributes to our fund for reporting on Health Issues, Senior Issues. If you would like to help support news in the public interest, click here.


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