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South Dakota Career Connector

Sep 10th 2018 4:10 pm Response: #370221 Your work policies are unworkable for disabled adults, and they don't solve the problem that Medicaid was created to solve - poor people need health coverage. This is just an excuse to boot people off of coverage.
Sep 14th 2018 9:46 am Response: #370533 I am asking the Center for Medicaid Services to not accept South Dakota's proposal to take Medicaid away from parents who don't meet certain requirements. Thank you, Eileen Brick
Sep 14th 2018 10:01 am Response: #370549 There are so many reasons to oppose SD's proposal to to take Medicaid away from parents who don't report enough work hours that I am forced to make a bulleted list of all of them:
>The proposal admits that 15% of these very low income participants will lose their Medicaid coverage. Why? Yes, support parents in getting jobs and improving their well-being, but don't do it by taking away their health care coverage!
>This proposal targets parents who live in deep poverty. It would create a catch-22 situation where hundreds of parents – mostly mothers – would lose health coverage if they don’t get jobs AND if they do. South Dakota’s failure to expand Medicaid to cover low-wage workers turns the proposed “work requirement” into a work penalty.
>There is so much "red tape" documenting work-related activities that it will cause people to lose coverage. Young parents, and others will mental health issues just can't keep up with it.
>Not enough support is available to address childcare and transportation needs of participants
>No state that now has Medicaid work requirements imposes this requirement on single parents of children as young as those in SD’s proposal. Approximately half, of those targeted in South Dakota are parents caring for children age 12 months to 6 years.
>The estimate is that 30% of the participants would be Native Americans and the impact would be “devastating” [according to the Tribal Chairmen's letter to the state] That in itself means Native Americans would be disproportionately impacted by South Dakota’s proposal and more likely to lose coverage than whites.
This list could go on!
I am writing simply to point out some of the major flaws in the proposal, to show you that concerned South Dakotans do care that we are not taking care of our citizens living in poverty in a state with the 4th-lowest hourly wages in the country, and to formally plead with the Center for Medicaid Services to reject SD's plan. Thank you for your consideration!
Sep 14th 2018 4:39 pm Response: #370701 I strongly support the South Dakota Career Connector application. Please see attached support letter.
Sep 15th 2018 4:23 pm Response: #370881 Please deny South Dakota’s request for waiver. Low wage earners need help to better their lives and putting them in a position that denies them access to health care does not move them toward a better life, it moves them away. Work requirements would likely do little to reduce poverty and would instead put many low-income employed parents at risk of losing benefits.
Sep 15th 2018 6:38 pm Response: #370889 Work requirements in Medicaid are illegal. Medicaid's objective is to provide medical assistance to low income people. Work requirements will create a barrier, instead of providing access to medical assistance. Work requirements are not listed as one of the eligible requirements in the Medicaid statute. The Secretary cannot create a whole new requirement of her own. This is illegal. Work requirements blocks access to medical assistance and causes beneficiaries to loose coverage. They run directly counter to what Medicaid is. They are illegal. Please do not approve this 1115 wavier.
Sep 16th 2018 11:29 pm Response: #370941 I don't think it is right to expect poor parents of young children to work in order to be covered by Medicaid. Most of the jobs they would be able to get wouldn't earn them enough to afford daycare for their children while they work - and if the job did pay well, they wouldn't qualify for Medicaid, so not only would they have to pay for childcare but also health insurance - makes no sense.
Sep 17th 2018 8:39 pm Response: #370973 So, South Dakota is applying for a Medicaid waiver. The waiver would take away health coverage benefits to make poor families healthier. That’s wrong and stands opposed to the goals of Medicaid.

“No republic is safe that tolerates a privileged class, or denies to any of its citizens equal rights and equal means to maintain them.” Frederick Douglass—1866.
Sep 18th 2018 12:16 pm Response: #371005 The attached comments are submitted jointly by the American College of Obstetricians and Gynecologists (ACOG) and ACOG's South Dakota Section. This comment letter includes citations to supporting research and documents for the benefit of CMS in reviewing our comments. We direct CMS to each of the items cited and made available to the agency through active hyperlinks, and we request that these, along with the full text of our comments, be considered part of the formal administrative record for purposes of the Administrative Procedures Act. To discuss these recommendations further, please contact Emily Eckert, health policy analyst, at or 202-863-2485.
Sep 18th 2018 4:09 pm Response: #371981 A society can be judged by how it treats its most vulnerable citizens. Taking Medicare away from the most disadvantaged South Dakotans is not what we stand for and what we work so hard to demonstrate. We are better than that! This is not the time and these are not the people who must be forced to get aid through work requirements that only increase their dependence and lack of hope. Find another solution, one that fits the reality low income people struggle with every day. Thank you.

Darrel Nelson
22882 Pine Meadows Ct.
Rapid City, SD 57702
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