• PIERRE, S.D. (AP) -- South Dakota legislative leaders from both parties said Friday they are discussing the possibility of expanding the Medicaid program to provide medical care for additional poor people, but much depends on how much flexibility federal officials would give the state in designing an expansion.
• Rep. Bernie Hunhoff, leader of the House Democratic minority, said discussions have focused on expanding Medicaid coverage only to those most in need and providing that an expansion would be halted if the federal government fails to meet its promise to pay most of the cost.
• "Change never comes easy," said Hunhoff, of Yankton. "I'm still confident we can do something on Medicaid this session."
• Rep. Justin Cronin, of Gettysburg, assistant leader of the House Republican majority, said federal officials so far have been reluctant to give states flexibility in expanding Medicaid. He said he continues to get a lot of phone calls and emails encouraging Medicaid expansion.
• "The discussions are definitely happening. We wouldn't be good stewards of the state if we weren't talking about options for what we can and can't do," Cronin said.
• Lawmakers doubt the Legislature would expand Medicaid to the full extent envisioned in the federal health care overhaul, but they are talking about seeking federal approval to extend coverage to a smaller group of low-income people.
• Federal officials last year rejected Gov. Dennis Daugaard's request to expand Medicaid only to a limited group. Daugaard has recommended that South Dakota not expand Medicaid, at least for now. The Republican governor has said the federal government is having trouble putting the health care overhaul into effect and he doubts it can meet its promise to pay the bulk of the Medicaid expansion costs.

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