RAPID CITY –Tribal Nations across South Dakota are putting their weight behind an upcoming ballot initiative that, if passed, will make affordable healthcare available to an additional 42,500 South Dakotans.

At a press conference held at the Hilton Garden Inn in Rapid City, tribal leaders from South Dakota gathered to endorse Amendment D. The Great Plains Tribal Leaders’ Health Board hosted the event. 

Joined by South Dakotans Decide Healthcare representatives, tribal leaders from the Rosebud Sioux Tribe, Oglala Sioux Tribe, Sisseton Wahpeton Oyate, Lower Brule Sioux Tribe, Crow Creek Sioux Tribe and Yankton Sioux Tribe, provided statements to the press on why they support Medicaid expansion.

Federal funding would pay for 95% percent of the expansion costs during the first two years, with the state responsible for the remaining 5 percent. Still, increased economic development and sales tax revenue in communities across South Dakota would cover these costs.

While Medicaid Expansion will benefit many South Dakotans, healthcare systems serving Native Americans in the state will see a significant increase in revenue from the passage of Amendment D, which tribal leaders say will help improve healthcare for tribal citizens.

Medicaid’s role as a source of revenue for Indian Health Service facilities has grown substantially due to Medicaid expansion in states that have opted into Medicaid Expansion. With the Indian Health Service underfunded annually by congress, individual service units and tribal healthcare facilities are burdened with finding new and creative ways of filling the funding gap. As a result, increasing the number of patients with third-party or Medicaid coverage has proven to be a successful strategy for supplementing limited purchase referred care resources and expanding capacity.

In Montana, according to the Montana Department of Public Health and Human Services, from 2016-2018, Medicaid expansion enrolled 15,288 tribal members generating as much as $174,400,000 in additional healthcare spending. For example, tribal and IHS-run facilities saw an additional $13.6 million for services reimbursed by the federal government during that time alone on the Blackfeet Reservation.

Federal law requires that additional third-party generated funding be reinvested into the healthcare system that created it. For example, the Oyate Health Center in Rapid City (a tribally managed 638-facility) is one example of a healthcare system that has already implemented strategies that have expanded coverage for its users. Under the management of the Great Plains Tribal Leaders Health Board, the Oyate Health Center has driven its uninsured rate down from 65% to 51% and hopes that Medicaid Expansion bolsters its efforts.

Tribal healthcare facilities use Third-Party revenue to create job opportunities for tribal members, expand services, and recruit providers. 

IHS and tribal facilities in states that have expanded Medicaid had the uninsured rate for nonelderly tribal citizens fall twice as much as states that did not expand Medicaid.

*Established in 1986, the Great Plains Tribal Leaders’ Health Board represents the 18 tribal communities in the four-state region of South Dakota, North Dakota, Nebraska, and Iowa. 

Serving as a liaison between the Great Plains Tribes and the various Health and Human Services divisions, including the Great Plains Area Indian Health Service, GPTCHB works to reduce public health disparities and improve the health and wellness of the American Indian people.

*South Dakotans Decide Healthcare is a broad non-partisan coalition of organizations dedicated to ensuring all South Dakotans have access to affordable, quality health care coverage. We represent organizations from health systems, including Avera, Monument, and Sanford, to advocacy organizations, including AARP-SD, American Cancer Society, Cancer Action Network, American Heart Association, and the Community Healthcare Association of the Dakotas, South Dakota Education Association, South Dakota Farmers Union, and many other organizations.