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said.
• Daugaard said South Dakota already covers about 115,000 residents on Medicaid, including about 80,000 low-income children, at a cost of about $300 million a year to the state. The program also covers pregnant women, low-income elderly residents and disabled people, but the federal law would expand coverage mostly for healthy adults, he said.
• The governor said expanding Medicaid "is something I'm not very enthusiastic about."
• "In a state like South Dakota, people still believe in self-reliance," he said. "I think able-bodied adults should be self-reliant."
• South Dakota officials have said expanding Medicaid coverage to more people under the law would force the state to spend an additional $99 million between 2014

and 2019. During those six years, the federal government would pay most of the cost of direct medical care for people added to the program, but the state would be responsible for extra administrative costs.
• Dave Hewett, president of the South Dakota Association of Health Care Organizations, said the hospitals, nursing homes and other medical facilities that belong to his group have supported the law. If more people have private insurance or are covered by Medicaid, more patients will be able to pay their medical bills, he said.
• South Dakota hospitals were unable to collect about $89 million for patient care in 2010, either through charity cases or bills people did not pay.
• South Dakota House Majority Leader David Lust, R- Rapid City, said the state would have trouble finding more money in the state budget to expand Medicaid. House Minority Leader Bernie Hunhoff, D-Yankton, said the law isn't perfect, but it gives South Dakota a chance to get more low-income working people insured.
• Meanwhile, U.S. Sen. John Thune, R-S.D., sided with Daugaard in his disappointment with the court's ruling. Thune said he and his fellow Republicans in Congress would continue efforts to repeal the law and take other steps to improve health care.
• His colleague, Democratic Sen. Tim Johnson, said the ruling provides a foundation for Congress to continue working to reduce health care costs and make sure more Americans are insured.
• South Dakota's lone member of the U.S. House, Rep. Kristi Noem, joined other Republicans in promising to continue to seek repeal of the law. Her opponent in the November election, Democrat Matt Varilek, said now that the law has been upheld, Republicans and Democrats in Congress should continue work to improve medical care and access to insurance while keeping costs down.

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