The South Dakota Association of Healthcare Organizations (SDAHO) recently submitted written comments to the South Dakota Department of Social Services regarding the proposed Section 1115 Medicaid Waiver. This waiver would implement work or community engagement requirements for certain adults covered under Medicaid expansion, in alignment with Constitutional Amendment F, approved by South Dakota voters.
SDAHO President and CEO Tim Rave addressed the comments to Secretary Matt Althoff, stating:
“I am writing as a neutral party regarding the Department’s proposed 1115 waiver for Medicaid work requirements. While SDAHO has opposed work requirements in the past—given the potential to cause thousands of South Dakotans to lose access to health insurance—we respect that the Department is fulfilling its obligation to voters. I would like to offer comments on the proposed exemptions and provide an example from another state.”
SDAHO expressed appreciation for the flexibility built into the proposed waiver, particularly the exemptions for individuals with serious medical conditions, those in intensive behavioral health treatment, and individuals experiencing emergencies or meeting nursing facility levels of care.
The organization strongly recommends the waiver include individuals with diagnosed mental health disorders. While these individuals might fall under some existing exemptions, many are not actively receiving treatment and may struggle to maintain stable employment.
“We are happy to engage further with the Department to ensure the most vulnerable are protected as this process moves forward,” added Rave.
SDAHO also pointed to Georgia’s Pathways Program—currently the only functional Medicaid work requirement program in the nation—as a case study. Since launching in July 2023, the program has cost over $86 million, with nearly three-quarters of the cost attributed to consulting fees, according to the Kaiser Family Foundation.
“If the waiver is approved,” Rave noted, “we hope South Dakota will have a strategy to ensure the implementation is, at worst, budget neutral for taxpayers.”
Click here to access the full comment letter
Read: South Dakota Proposed Medicaid 1115 Waiver Demonstration for Work Requirement
