The state task force on Medicaid opportunities and challenges is working on the final version of its report today in Pierre. The 19-member panel was appointed by Gov. Dennis Daugaard and its draft version of the report reflects the efforts by the participants. The report’s executive summary is yet to be completed, but the draft uses a five-section approach:
1. — General background;
2. — State decision points;
3. — Medicaid expansion findings;
4. — Medicaid expansion findings (pros and cons); and
5. — Implementation recommendations if the governor and the Legislature decide to proceed with Medicaid expansion.
The draft stands at 42 pages. The implementation recommendations point to how the Legislature and governor might fashion legislation, rules and policies. One key point in the recommendations is a “circuit breaker” that would allow South Dakota to immediately terminate the program if the federal share of funding falls below the promised 90 percent. This has been done by other states, according to the report.
Other recommendations include payment reform, such as for outpatient services; start-up to coincide with a July 1 start of a state fiscal year, with six months for organization and start-up; investigate cost-sharing by Medicaid patients; consider strains on healthcare workforce, especially in dentistry; establish a monitoring system regarding access and quality; look for ways to use additional Medicaid funds to invest in more access and preventative care; resolve outstanding issues with the federal government before committing to expansion; and look into how Medicaid expansion and federal health-insurance exchange coverage potentially can be blended.
The task force’s final report is due Sept. 15. It appears to be a good road map for the decisions ahead, especially for legislators who will have to make many complex decisions in the overall busy-ness of the 2014 session.