Medicaid work requirement would undermine election, threaten cancer care

February 6, 2023 5:04 pm
A Sioux Falls election polling place on the morning of Nov. 8, 2022. (Joshua Haiar/South Dakota Searchlight)

A Sioux Falls election polling place on the morning of Nov. 8, 2022. (Joshua Haiar/South Dakota Searchlight)

Just a few short months ago, South Dakotans voted, by a wide margin, to provide access to affordable health care. They voted to help thousands of fellow South Dakotans stuck in the coverage gap, and they voted to prevent the Legislature from adding additional burdens to that access.

Before Medicaid expansion is even implemented, politicians in Pierre are already trying to undermine the will of the people. Their resolution will add layers of administrative red tape between South Dakotans and their doctors and quite literally take health insurance away from cancer patients.

Moving HJR 5004 forward would be an insult to South Dakota voters, 82% of whom want the state to move quickly to implement Medicaid expansion as it is now in our state constitution. What’s more, it would be a major step backward for cancer patients and survivors in our state. This year, 5,340 South Dakotans will be diagnosed with cancer, and the disease will kill 1,760 of us.

Expanded Medicaid eligibility, as it is currently in our state constitution, promotes earlier cancer detection, fewer deaths, and improved outcomes for patients. Consistent access to screening and treatment is crucial to seeing these positive impacts.  This resolution would create further uncertainty in those efforts and put cancer patients at risk of losing coverage in the middle of their treatments.

House sends Medicaid work requirement ballot measure to Senate

At the American Cancer Society, we know that cancer patients in active treatment are often unable to work or require modifications in their employment due to their treatment. Between 40 and 85 percent of them stop working and their absences range from 45 days to six months. Many cancer survivors also continue to deal with chronic issues as a result of their treatments that impact their ability to work.  We have found that the complexity and frequency of administrative reporting requirements, like those in HJR 5004, have led to thousands of people losing their Medicaid coverage. For a patient who is mid-treatment, a loss of health care coverage could seriously jeopardize their chance of survival.

Medicaid work requirements could hinder access to lifesaving preventive services, as well. Individuals without health insurance are diagnosed with cancer at later stages when the disease is more expensive to treat, and survival is less likely.

This resolution won’t have the effect South Dakota politicians think it will. We know because we’ve seen it tried in other states. Arkansas’ work requirement increased uninsured rates without increasing employment, studies by Harvard researchers found. People who lost Medicaid did not transition to other coverage and there was no evidence that it increased employment.

Every day, we hear stories from cancer patients and cancer survivors — truly inspiring stories of South Dakotans getting care and triumphing over this deadly disease.  But we also hear stories that are heartbreaking. A retired physician in Yankton told us of a patient who came to her and was diagnosed with breast cancer. This patient did not have health care and did not then qualify for Medicaid. She said to that doctor that she would not bankrupt her family and left the office. She, like many other South Dakotans, had to choose to forgo much-needed health care because of her financial state. The doctor said she was crestfallen when she read that patient’s obituary in the paper some month later.

This resolution would cost state resources to put it on the ballot and more state resources to enforce, all in the unlikely chance that the federal government approves it. The people of South Dakota have spoken loud and clear, but that seems to be falling on deaf ears in Pierre. Consistent access to health care coverage is a matter of life and death for thousands of low-income cancer patients and survivors.



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Matthew McLarty
Matthew McLarty

Matthew McLarty is a Sioux Falls resident and the South Dakota government relations director for the American Cancer Society Cancer Action Network. He is dedicated to leveraging the power of government to end suffering and death from cancer.