Public News Service

By: Roz Brown

South Dakota is not one of 33 states that expanded its Medicaid program under the Affordable Care Act, but a new report contends that if it had done so, more rural low-income residents would be covered by health insurance. The report from Georgetown University showed that states without expanded Medicaid have big coverage gaps. Study co-author Joan Alker, executive director of Georgetown’s Center for Children and Families, said the uninsured rate for low-income adults has dropped since about 2008 in nearly all states, but the sharpest declines were seen in small towns and rural areas in states that have expanded Medicaid. “The major finding,” she said, “is that states that expanded Medicaid saw more than three times the rate of decline in the uninsured adult population in rural areas and small towns than those that did not expand Medicaid under the Affordable Care Act.”

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“Our report found that the uninsured rate for low-income adults in South Dakota in rural areas is a whopping 47 percent,” she said. “So almost one in two of these folks are uninsured as compared to 41 percent in metro areas.”

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