We've now completed the seventh week of work in Pierre.   We passed "cross-over" on Feb. 25th, and now will focus on Senate Bills, just as the Senate will take up the bills which have passed the House. When bills are passed by the other body, but with changes that may not be accepted by the other legislative body, they must end up in a conference committee to iron out the differences.
• The last couple weeks of each Session have a lot of moving parts as the Appropriations Committee gets the final revenue numbers, adjusts the budget accordingly, and figures in the cost of any new legislation which passes which impacts the General Fund.  We have passed several bills this week dealing with higher education

projects, including a new football stadium and swine unit at SDSU, remodeling the Madison city hospital to serve as a new classroom building at Dakota State, adding science lab space at BHSU to work with the Deep Underground Science space at Lead,  and expanding the addition of the Johnson Fine Arts Center at Northern.  None of these projects use a dime of tax money.  Private fundraising or student fees, in the case of classroom facilities, are paying for all of the projects.
• Our Caucus views Medicaid Expansion as the single most important decision made this session. Democratic leadership is in continual communication with the federal offices of Health and Human Services and is working cooperatively to get something done-hopefully still this session.
• States have been trying to find ways to provide health care coverage to low-income adults for decades and they've largely failed. There are an estimated 48,000 South Dakotans in that category. They are mostly single adults working in low-wage jobs that don't provide insurance. A recent study released by the New England Journal of Medicine said that 94 lives in South Dakota would be saved each year from Medicaid Expansion.
• Perhaps it's not a problem for the uninsured; that is until they have a health problem. Even then, they usually get medical care. But it's not always done in an efficient way. Too often, they show up in expensive emergency rooms. Or they wait to see a doctor until a small problem becomes a big deal.
• The cost is usually absorbed by the clinics and hospitals. But they have to charge the rest of us more to cover the charity care. One study suggested that we all pay $1,000 more a year just in premiums to cover the uninsured. We also pay higher taxes because some of the costs are born by county governments.
• And it costs us in other ways. If an uninsured worker doesn't get health care, he or she sometimes becomes less productive at work. And they are always just a broken arm or leg away from bankruptcy.

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