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thousands of additional low-income people in the program.
• Sen. Stand Adelstein, R-Rapid City, proposed that about $1.5 million in state money be added to the state budget so South Dakota could get $58.3 million in federal funds to expand Medicaid and cover an estimated 48,000 additional people under the federal health care overhaul.
• But the Joint Appropriations Committee voted 13-5 to reject Adelstein's plan.
• Deb Bowman, a senior adviser to Daugaard, said the Republican governor will appoint legislators and others to a study committee that will make recommendations on the advantages and disadvantages of expanding Medicaid.
• If the Legislature decided now to expand Medicaid, the additional people would not be covered until Jan. 1, when that part of the federal health care law takes effect, Bowman said. If the Legislature delays a decision for a year and then passes an expansion, the additional people would be covered by July l next year, she said.
• Daugaard has recommended that South Dakota delay a decision on whether to expand Medicaid because he is uncertain the federal government can afford to meet its pledge of paying most of the cost. The governor also continues to ask federal officials for flexibility to limit the expansion to only part of the 48,000 who would otherwise qualify.
• Adelstein said the Legislature should approve a Medicaid expansion now to provide health care to the working poor as soon as possible.
• In addition, hospitals have said they are unable to collect about $90 million a year from low-income patients who have no insurance and are unable to pay their bills, Adelstein said. Hospitals then charge insured patients more to offset losses in (Continued on page 44)
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