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Medicaid expansion, on behalf of the association's 200 members.
• A study conducted in Oregon found that adults who gained Medicaid were more likely to report that they were healthy, and more likely to have a regular doctor and to receive preventative care. Self-reported mental health improved notably--perhaps in part because the stress of medical costs was diminished. "Medicaid virtually eliminated catastrophic out-of-pocket medical spending for the adults who gained coverage," according to a Kaiser Family Foundation report.
• "Oftentimes, a person's health care takes second place to everything else they have," said Jay Jahnig, administrator for the Faulkton Area Medical Center. "If they can't afford to see the doctor they don't. They nurse that cough, or suffer through whatever it is that has ailed them ... The new laws will allow them to get that care. This will keep the general population healthier."
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• Gains for hospitals
• Rural hospitals would also miss out on some benefits.
• Sebelius said the expansion would be good for critical access hospitals, "who are now serving people, many who don't have coverage," but will "now have paying customers."
• Two are hospital administrators agreed, but said the effect on them specifically would be minimal.
• "Speaking as a hospital administrator, getting paid something for a bill is better than getting paid nothing," Jahnig said. "The problem of uninsured patients should be minimized if the system works. We are fortunate here in Faulk County, at our hospital. We only have about 3 percent of our patients as Medicaid patients. Some hospitals, and some of these are hospitals I worked for another state, I've seen 30 to 40 percent Medicaid patients. This means that a lot of hospitals nationwide are strapped for cash, because Medicaid doesn't quite pay costs."
• Nick Fosness, administrator of the Marshall County Healthcare Center, said that the Medicaid expansion wouldn't affect their hospital very much either.
• "It wouldn't have a big impact on us because we are a low Medicaid user with most of our patients having private insurance or Medicare," Fosness said. "It's the uncompensated care that is the lure for hospitals because it represents a large dollar amount for some of them."
• The South Dakota Budget & Policy Project found that all S.D. counties would have additional residents eligible for Medicaid if South Dakota expands the program. Pennington and Minnehaha have the most such residents (more than 5,000), while Faulk, Clark, Edmunds and McPherson are among the counties with the fewest (under 250).

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