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• Senate Minority Leader Jason Frerichs of Wilmot said he hopes the Supreme Court doesn't throw out the entire law because he supports the goal of getting more people covered by insurance. Regardless of whether the federal law is struck down or repealed, South Dakota should explore setting up a health insurance exchange of its own or in cooperation with other states to help more people buy affordable insurance and get medical care, he said.
• "In the end, we still have real people who are affected," Frerichs said.
• The Supreme Court could uphold or strike down the entire Affordable Care Act, or just throw out portions of it.
• About 105,000 South Dakotans, 13 percent of the state's population, didn't have

insurance in 2010, according to the U.S. Census Bureau. But based on their own survey, state officials believe only 71,000, or about 9 percent, are uninsured.
• Deb Bowman, a senior adviser to the governor, said about 115,000 South Dakotans are now on Medicaid at a cost to the state of $297 million a year, nearly a quarter of all state spending. The federal health care overhaul would change eligibility requirements to add an additional 54,000 to the program in 2014 -- 48,000 newly eligible and the rest those who could be on Medicaid now but haven't signed up, she said.
• The federal government would initially cover all costs for the additional people on Medicaid, but the state would have to cover 10 percent of the medical costs by 2019, Bowman said. The extra state cost, including administration, would total $99 million in 2014-2019, she said.
• Daugaard and Frerichs agreed the state would not expand eligibility for Medicaid unless forced to do so by the federal law.
• Daugaard said if more people qualify for Medicaid, many would drop their private insurance to move to the government program. A requirement that small businesses provide health insurance to employees likely would backfire because businesses could save money by dropping insurance coverage and paying a penalty for doing so, he said.
• Frerichs said whatever the fate of the federal law, South Dakota should manage Medicaid to help people leave the program and get private insurance.
• "We shouldn't expect them to be there forever," the Democratic Senate leader said.
• Dave Hewett, president of the South Dakota Association of Health Care Organizations, said the association of hospitals and other health operations generally supports the federal law because it would reduce the number of people without insur

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