• Last Tuesday we heard from Social Services, the largest budget in state government, in Appropriations Committee.  Our Medicaid eligibles continue to run below budget projections, which is good news.  Unfortunately, the number of disabled citizens who need expensive custodial care is increasing. Also, because South Dakota's economy is doing so well, our state share of the Medicaid expenditure is increasing and the federal share is decreasing, and that takes more state tax dollars. This is a department where $20 million has been tucked away into a reserve fund because of administration concerns about the difficulty in budgeting for those services. I do not believe the department was justified in this action, and it effectively took money that could have been spent on education or Medicaid last year.   
• A special briefing for legislators on Medicaid expansion was presented by the Council of State Government last week. CSG is a nonpartisan association which serves all three branches of state government.  The speaker was Dr. Vern Smith, a nationally known health care economist and the former Medicaid director in Michigan. Dr. Smith was able to relate the experiences of other states, some of which have expanded Medicaid eligibility years before the recent federal proposal. In studies which reviewed these expansions, people were healthier, and less health care was obtained in emergency rooms.
• The numbers change often, but to date close to half the states have decided to expand Medicaid coverage. If our state follows suit, the federal government would cover 100 percent of Medicaid costs for the estimated 48,000 newly-eligible SD adults for the first three years (2014 - 2016).  The state's expense would be a little over a million dollars a year for administration.  The state's share would gradually rise until it reached 10 percent of total costs in 2020.  According to the Department of Social Services estimates, the new eligibles would receive about $2 billion in medical care benefits between 2014 and 2020.  Not a bad deal!
• Michigan Governor Rick Snyder announced that his state will expand Medicaid. Snyder, a Republican joins fellow Republican governors of Arizona, Nevada, New Mexico and North Dakota who have recently said they would expand the program. While it is a difficult decision, failure to act will leave more South Dakotans without medical coverage and continue to drive them to emergency care when they do need help. The federal dollars we turn down will be distributed to other states, not "saved" or applied to federal spending more to our liking.
• Factoid for the day:  Vehicle license plates are scheduled to be replaced in 2016, according to Secretary of Revenue Andy Gerlach.
• Last Thursday I testified before the House Taxation Committee on the need for more revenue in South Dakota to fund government services. I know it's not a popu