“With people who are put on Medicaid, you take people’s purpose, you take people’s dignity,” Moore said. “People need to work.”
But advocates say South Dakotans who need health care are already working; the state’s unemployment rate is 2.3%, the lowest figure in more than a decade. The prospect of new jobs is one of the reasons the board of directors of the South Dakota Chamber of Commerce and Industry voted in favor of Amendment D in September after a “healthy debate”, a said David Owen, its chairman and chief lobbyist.
“Injecting money into the health care system will help stabilize and create health care jobs,” he said. “When you actually look at this, you just have to conclude that we’re keeping South Dakota money here.”
Enlargement supporters are confident because there has already been a test vote. In the state’s primary election in June, voters rejected a ballot measure that would have required a 60% majority to approve any constitutional amendment. This measure, known as Amendment C, was widely seen as an effort by opponents of Medicaid expansion to thwart it.
“They put all their eggs in one basket,” Mr Owen said. “It did not work.”
After Amendment C failed, donations from Americans for Prosperity and other opponents dried up, said State Sen. John Wiik, a Republican leading the fight against the expansion. Referring to major health care organizations in the state, he said, “I kind of feel like I’m up against three big old medical Goliaths, here all alone.”
A recent South Dakota State University survey found that 53% of likely voters supported Medicaid expansion, 20% opposed it, and 27% were undecided. The coalition supporting the amendment, which calls itself South Dakotans Decide Healthcare, has raised more than $3 million, most of it from health care organizations, according to campaign fundraising documents. Mr Wiik said his side raised “absolutely zero”.
Still, Mr. Wiik said he remained hopeful. He said Republicans in the state legislature have taken steps to expand access to care by increasing reimbursement rates for health providers and helping the South Dakota Farm Bureau improve its health insurance offerings. . (The Farm Bureau leans Republican, while the Farmers Union leans Democratic.)
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