Tens of thousands of South Dakotans to be eligible for Medicaid July 1

A Medicaid expansion plan approved by the legislature takes effect in a matter of weeks.

Officials estimate around 50,000 South Dakotans will gain access to health care. And advocates are working to spread awareness.

Medicaid expansion applications will go into effect July 1. Newly approved applicants will have coverage to visit a medical professional after the 4th of July weekend.

Penny Kelley is an outreach and enrollment program manager for Community HealthCare Association of the Dakotas, or CHAD. She along with other health care advocates spoke at the Medicaid Partners Summit in Sioux Falls Thursday.

She said starting July 1, most Medicaid applicants will be covered with lower premiums.

“Once again, thanks to the Affordable Care Act, I talk about it a lot, insurance is more affordable now than ever. In fact, four out of five people will get premiums less than ten dollars a month,” said Kelley.

Kelley said gaining greater access to those in need and informing them of the change is imperative.

She said even with the changes, each Medicaid program covers multiple medical needs.

“The plans are required to be quality comprehensive plans. They have to cover doctor visits, emergency care, preventative care, prescriptions, hospital care, and it is also important to note that they cannot reject, charge more, or refuse to pay for essential health benefits due to a pre-existing condition,” said Kelley.  

Matt Althoff is the Cabinet Secretary for the Department of Social Services. He said the state Department of Social Service is prepared to assist the thousands of South Dakotans that are currently “slipping through the net.”

“There is an incentivization for those of you who are unaware. The F-map, there is a federal bonus to the state match to incentivize the state to go into this expansion mode, but then that leads to a cliff,” said Althoff. “This reality that your experience goes up, and so we are prepared we do all that we can to adjust when we do. We’ll see it coming.”

DSS staff and community health care workers across the state are trained to help applicants complete the process and are available to answer Medicaid expansion questions.