PIERRE, S.D.-- The reform race is on, and South Dakota's longest tenured congressional leader is feeling optimistic.
Amid the nonstop year of health care reform debate, U.S. Sen. John Thune took some time Thursday to visit with the Rotary Club of Mitchell. After meeting with approximately two dozen Rotarians, Thune in an interview talked about the two major reform efforts facing Congress.
And he said Senate Republicans are hoping for a win.
"Well, if we don't pass health-care reform and tax reform, we will get routed in the midterm elections, yes," Thune said. "And we should. We need to be accountable."
But it might not come to that.
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Thune said the Affordable Care Act reform bill introduced by Republican U.S. Sens. Bill Cassidy, of Louisiana, and Lindsey Graham, of South Carolina, will provide huge benefits to South Dakota, particularly the addition of a per capita cap on Medicaid spending.
The bill comes as the Centers for Medicare & Medicaid Services projected 48.52 percent of the counties in the nation will have one provider on the health care exchange next year, and more than 2.69 million Americans are projected to have no choice on their health insurance provider.
South Dakota still has two providers on the exchanges, which Thune said is down from 17, and he said premiums have risen 124 percent in the state. Not only have premiums risen, Thune said he's heard from farmers and ranchers who are paying $2,000 to $2,500 per month on health insurance for their families.
"The thing is, and this is the point about it, it doesn't get better," Thune said about Obamacare. "The Obamacare exchanges right now, the individual market is just going to freefall."
Thune said Congress needs to establish an individual marketplace that works, and fellow U.S. Sen. Mike Rounds echoed the same concerns during a call with media from Pierre on Thursday afternoon.
Like Thune, Rounds sees an immense benefit for South Dakotans through the Graham-Cassidy bill. South Dakota was one of the minority of states that did not expand Medicaid under the Affordable Care Act, but the state is set for a huge funding increase if the Graham-Cassidy bill moves forward.
"Some people have suggested South Dakota loses money under this program, it does not," Rounds said. "Under this proposal, over the period from 2020 until 2026, Sens. Graham and Cassidy through their calculations working with Health and Human Services, have indicated South Dakota will receive about $2.2 billion between 2020 and 2026."
That number, Rounds said, is $1.3 to $1.4 billion larger than it would have been without the bill. And he said the federal government assuming 100 percent of the cost for Medicaid-eligible Native Americans is a major contributing factor.
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The bill maintains coverage for people under 26 years old who are on a parent's plan and removes the individual and employer mandate enacted under the ACA, among other provisions. But the South Dakota Democratic Party last week said that the bill would "end Medicaid as we know it, cancel tax credits that help families afford health insurance and eliminate subsidies that reduce out-of-pocket costs for working families."
But in Thune's eyes, the Graham-Cassidy bill is mere votes from clearing the first hurdle in the Senate.
"We're right there," Thune said. "It's going to come down to trying to swing the last couple votes."
