Medicaid expansion enrollment starts July 1, but some may be eligible to apply early

Some 52,000 South Dakotans will be eligible for Medicaid on July 1 after South Dakota voted to expand the program in November. But for some potential Medicaid participants, they can start the application process now in order to have health insurance come July 1.

During an event Thursday, which saw one woman apply for Medicaid coverage at the Falls Community Clinic in Sioux Falls, doctors and supporters of Medicaid expansion spoke about what the increased eligibility will mean for those who cannot currently afford health insurance.

Medicaid is a federal-state health insurance program for low-income people. The South Dakota Department of Social Services has budgeted $578.9 million to fund the benefit and administrative costs for Medicaid expansion and has added 68 full-time employees to staff the department.

Jennifer Tinguely, a family practice physician at Falls Community Clinic, said over half of the clinic's patents are uninsured.

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She explained that with Medicaid expansion, patients between the ages of 18 and 65 who make less than $20,000 or families of four that make less than $41,000 will become eligible for Medicaid.

"I hope we see more patients, but I absolutely know that we will have more patients that have insurance," Tinguely said.

Lisa Thompson, a 58-year-old Mitchell resident, fell into what's known as the "Medicaid gap" when she moved back to South Dakota after living in the Twin Cities region of Minnesota. Thompson, a freelance writer, Uber driver and babysitter, had qualified for Medicaid in Minnesota but when she moved to Mitchell, she was unable to get health insurance because she didn't meet the South Dakota Medicaid income requirements.

That meant she couldn't afford medication she needed to manage her chronic illnesses. At times she was unable to walk without a walker or scooter due to broken bones she suffered after falls, and she had daily challenges with her depression.

"While I had started working as a nanny for an 18-month boy whom I adored, I had to quit this position because there were days I couldn't function well enough to consistently provide the care for him that he needed," Thompson explained.

Thompson was able to apply for Medicaid coverage at the Falls Community Clinic Thursday and called it a "great day."

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Tinguely said Falls Community Clinic had already been educating people about Medicaid expansion and had employees in place, known as Navigators, who will be able to help people like Thompson apply for coverage.

"We have always been working with patients here to try and get them the care that they need in the most affordable way," Tinguely said.

Medicaid expansion will help patients cover costs related to hospitalizations, pregnancy, mental health and substance use disorder services, oral and vision care, and more.

South Dakota started scrubbing the Medicaid rolls in April after federal pandemic protections expired. However, DSS estimated the 10,000 to 12,000 people who were flagged as "ineligible" could become eligible for Medicaid once again because of the expansion.

This article originally appeared on Sioux Falls Argus Leader: South Dakotans may be eligible for early Medicaid expansion enrollment