Coalition created by Daugaard focusing on funding to expand Medicaid in South Dakota

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FORT PIERRE, South Dakota — A coalition of health representatives and state and tribal officials established by Gov. Dennis Daugaard to explore the possibility of expanding Medicaid in South Dakota is first focusing on how to free up enough funds to pay for the state's share.

The Health Care Solutions Coalition met for the first time Wednesday in Fort Pierre. The Daugaard administration has broadly outlined to federal officials a proposal to expand the health coverage program for low-income and disabled people and the federal government is taking the ideas seriously, said Kim Malsam-Rysdon, a senior adviser to the governor.

Members of the coalition will work out the details of paying for the state's share, which would be offset by savings to make up for the expected cost of between $30 million and $33 million starting in 2020.

"We're not talking about expansion unless we can free up the funding to do it," Malsam-Rysdon said.

The Republican governor met last week with Health and Human Services Secretary Sylvia Burwell to explain the plan. A spokesman for the department said in a statement that the administration is "willing to work with any state interested in expanding Medicaid."

The proposal, which is in its early stages, would make about 48,500 South Dakota residents newly eligible for the program. The federal government in 2014 rejected a plan from the state to partially expand Medicaid.

The proposal aims to pay for the state's share in part by expanding access to services that are fully funded by the federal government, with the goal of freeing up enough state funding to pay for the addition of more residents to the Medicaid program.

Officials are focusing on people who are eligible for Medicaid but can get services through the Indian Health Service. The goal is to make services through the Indian Health Service more accessible so that people don't have to go to an outside health care provider, which can happen if the IHS is unable to offer a specific service.

Those services at the IHS are fully funded by the federal government through Medicaid rather than through the typical split in financing between the state and the federal government. The state is also asking for a change in the classification of some services to have them fully paid for by the federal government.

The administration also wants to improve access to care on the state's reservations. The response to the proposal from Native American tribes in the state has been promising, said Jerilyn Church of the Great Plains Tribal Chairmen's Health Board.

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