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Thousands of South Dakotans could lose Medicaid soon

In 2015, Medicaid spending topped $552 billion nationwide. People who receive both Medicaid and Medicare and people with disabilities account for more than half of Medicaid spending.
Katarzyna Bialasiewicz/Getty Images/iStockphoto
In 2015, Medicaid spending topped $552 billion nationwide. People who receive both Medicaid and Medicare and people with disabilities account for more than half of Medicaid spending.

Thousands of South Dakotans could be without Medicaid coverage in the coming months.

That’s because the South Dakota Department of Social Services is purging its pandemic Medicaid rolls following the coronavirus public health emergency expiration.

An early pandemic relief bill said states are prohibited from making Medicaid eligibility standards more restrictive and from terminating people’s coverage. Federal dollars would match the increase.

That public health emergency has lapsed.

Nationally, an estimated 15 million people will lose coverage. The department said April data related to Medicaid's unwinding in South Dakota is not yet available.

Since March 2020, the South Dakota Department of Social Services said Medicaid enrollment increased over 30 percent—from about 115,000 to nearly 152,000.

That increase was due in part to the first federal coronavirus relief package in early 2020.

DSS said it started notifying Medicaid applicates in February.

"While completing renewals during unwinding, DSS is screening for eligibility for Medicaid Expansion," said department Secretary Matt Althoff in a statement. "Individuals who lose coverage due to unwinding yet appear they may be eligible for Medicaid Expansion are being sent multiple notices of their potential coverage through Medicaid Expansion beginning July 1."

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South Dakota, along with four other states, announced in February it would start scrubbing its Medicaid rolls as early as it could, which was April 1.

A DSS memo titled ‘Unwinding the Continuous Coverage Requirement' said the department will focus first on "cases most likely to be ineligible based on those who no longer meet a coverage group."

The Medicaid unwinding comes as the department is also preparing to expand the health care program for low-income individuals. A voter-approved initiative will expand Medicaid coverage to adults with income up to 138 percent of the federal poverty level.

It is unclear how many South Dakotans that lose Medicaid coverage will qualify for it again under expansion.

The Department of Social Services said it will take about nine months for it to work through all Medicaid cases. Expansion becomes law on July 1, which means some Medicaid recipients could go a month or two without coverage.

Lee Strubinger is SDPB’s Rapid City-based politics and public policy reporter. Lee is a two-time national Edward R. Murrow Award winning reporter. He holds a master’s in public affairs reporting from the University of Illinois-Springfield.