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Mission:

Mission:. Medicaid Expansion – a South Dakota Decision. To promote responsible and equitable fiscal policies through research and education. Joy Smolnisky, Director 808 N. West Ave., Sioux Falls, SD 605-367-9667 joys@sdbudgetandpolicyproject.org http://sdbpp.org

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Mission:

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  1. Mission: Medicaid Expansion – a South Dakota Decision To promote responsible and equitable fiscal policies through research and education Joy Smolnisky, Director 808 N. West Ave., Sioux Falls, SD 605-367-9667 joys@sdbudgetandpolicyproject.org http://sdbpp.org Funded through a grant from the Northwest Area Foundation

  2. Federal Affordable Care Act includes: • Coverage guarantees • Insurance exchanges • Federal tax credits to • pay for insurance • 4. Individual mandate • 5. Funding provisions regardless of SD decision on Medicaid expansion

  3. 2012 Federal Poverty Level (FPL) by household size *138% minus 5% income disregard = 133% FPL

  4. 2014 FEDERAL TAX CREDITS TO MAKE PREMIUM COSTS AFFORDABLE 92,800 South Dakotans eligible

  5. FEDERAL TAX CREDITS – Cost Sharing 1/3 of out-of-pocket cap 1/2 of out-of-pocket cap 2/3 of out-of-pocket cap

  6. *Based on income as a percentage of the Federal Poverty Level by household size

  7. 400% FPL 2014 federal insurance exchange subsidies (sliding scale) 100% FPL

  8. 400% FPL 2014 federal insurance exchange subsidies (sliding scale) South Dakotans without access to affordable health insurance 100% FPL

  9. South Dakotan health insurance in 2014 92,800 116,000 30,000 uninsured South Dakotans

  10. SCENARIO #2 (without Medicaid expansion) Susan Frank Mary Willis Susan and Mary are both single parents. Susan’s daughter Sarah and Mary’s son Zeke are first grade classmates. These moms both work full time. Susan’s earnings Mary’s earnings $7.50/hour – 38 hrs/week $7.75/hour – 38 hrs/week 98% FPL (Federal Poverty Level) 102% FPL (Federal Poverty Level) Can these moms get affordable health insurance? NO YES Susan’s income is TOO LOW to Mary’s HIGHER income is qualify for federal subsidies eligible for federal subsidies. (below 100% FPL) and too high Her insurance premium cost to qualify for SD Medicaid will be less than $310 a year.

  11. SCENARIO #3 (without Medicaid expansion) Bob & Cathy Nick & Deb Olsen Hansen The Olson Hansen families each have two children, ages 6 months and 3 years old. Each dad works full time while mom is home taking care of the children. Olson family earnings Hansen family earnings $10.90/hour $11.15/hour (98% FPL) (101% FPL) Can these parents get affordable health insurance? NO YES Bob’s income is TOO LOW to Nick’s HIGHER income makes both qualify the parents for federal subsidies parents eligible for federal subsidies (below 100% FPL) and too high Their insurance premium cost to qualify the parents for SD Medicaid. will be less than $500 a year.

  12. exchange subsidies 138% FPL 100% FPL

  13. November 2012 Kaiser Commission Estimates (million) 1 yr cost 1 yr cost 10 yr cost 2016 2022 2013-2022 • SD: $ $1 $ 36 $157 % 0.3% 5% 2.9% Fed: $ $214 $307 $2,110 % 25.9% 25% 22.8% *Table 6,7, & 8 Kaiser Commission on Medicaid and the uninsured. “Cost and Coverage implication of the ACA Medicaid Expansion National and State-by-state Analysis” November 2012

  14. Medicaid expansion Which road does SD take?

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