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Medicaid expansion enrollment lower than anticipated

SD DSS Secretary Matt Althoff testifies in favor of a proposed Medicaid work requirement ballot question for voters.
Lee Strubinger
/
SDPB
SD DSS Secretary Matt Althoff testifies in favor of a proposed Medicaid work requirement ballot question for voters during the 2024 legislative session.

The number of new Medicaid expansion enrollees in the last two months is less than 1,000.

That’s according to recent data from the Department of Social Services, which is enrolling individuals at a rate much lower than expected.

There are currently 22,600 individuals enrolled in Medicaid through expansion. That’s about 7,500 less than anticipated.

DSS

The lower enrollee amount coincides with the rollout of a new Medicaid eligibility system called BEES, which launched on March 4.

Department of Social Services Secretary Matt Althoff said the department saw a slowdown in productivity during the launch, which included a full week of training in February.

“It has been very, very smooth despite all those innovations,” said DSS Secretary Matt Althoff during an interim appropriations hearing on Tuesday. “That says to me as cabinet secretary that our team is increasing in their proficiency, their depth of understanding, because every application is unique.”

The percentage of Medicaid expansion enrollees increased by 302 people in the month of March, a 1.4 percent increase. In April, the number of new Medicaid expansion enrollees was 491, an increase of 2.2 percent.

The Department of Social Services expects 40,000 South Dakotans to receive Medicaid benefits by the end of the year.

DSS

Althoff said there are a lot of factors contributing to slow enrollment.

“What I would urge is that we take caution to jump to conclusions form that, as this is still a very young program. The fact is the data is the data," Althoff said. "We’re below the budget, if you will, on total enrollment and we don’t know why.”

Althoff said the state is already seeing churn within the Medicaid expansion population. About 4,000 individuals have already dropped coverage—whether they’ve moved out of state, died or gained higher wages.

According to DSS, 95 percent of expansion enrollees have had at least one claim paid for by Medicaid.

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.