• PIERRE, S.D. (AP) --Now that President Barack Obama's re-election has cleared the way for the full implementation of his health care law, doctors and hospitals in South Dakota are urging the state to expand its Medicaid program so thousands of additional low-income residents can receive coverage.
• But Gov. Dennis Daugaard says any expansion of coverage is unlikely for at least several years while the potential costs are examined.
• The South Dakota Association of Health Care Organizations said about 48,000 uninsured residents will be left behind if South Dakota doesn't ease its eligibility requirements for Medicaid, the government health care program for the poor.
• "If we're left out of the benefits that can come from the Affordable Care Act, how do we take care of the people of South Dakota who are below the federal poverty level?" said Dr. Rob Allison, of Pierre, president of the South Dakota State Medical Association.
• The federal law seeks to reduce the number of uninsured by requiring those who can afford coverage to obtain it. But the Supreme Court ruled that states cannot be required to expand Medicaid to cover more of those who can't afford policies.
• Daugaard said he would consider expanding Medicaid after more is known about the impact and how much flexibility the state will have in administering the program.
• "You can wait, evaluate your budget situation, see how your economy is going, and see how your Medicaid costs are coming into control," the governor said.
• Daugaard, along with many other Republican governors, opposed the new law and had hoped it would be repealed if Obama was not re-elected. The new health law's first postelection deadline is Friday, when states must notify the federal Health and Human Services Department whether they will set up an online marketplace for residents and businesses to use in shopping among competing policies. Daugaard announced in September that South Dakota instead will let the federal government operate and pay for the online system, known as an exchange. Coverage is slated to begin in 2014.
• Dave Hewett, president of the state health care association, said all patients will suffer if more low-income residents aren't allowed into Medicaid. He said people without coverage often delay getting medical care until they are very sick and then show up at hospital emergency rooms. Since they can't afford to pay for expensive emergency care, hospitals have to charge insured patients to offset losses in charity

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