South Dakota: Donald Trump may have already doomed 50,000 people.

He hasn't even been sworn in yet:

A proposal to expand a federal health insurance program for needy people could be off the table following the results of Tuesday's election.

The victory of Republican Donald Trump, who has called for a repeal of Obamacare, along with the increasingly conservative Republican make-up of the South Dakota state Legislature could thwart Gov. Dennis Daugaard's efforts to expand Medicaid in the state.

Daugaard for more than a year has worked with the Obama administration and the Indian Health Service to strike a deal, which stemmed the approval of a federal policy that allows the state to spend less on Medicaid-eligible Native Americans. And part of that bargain has been staked on South Dakota using the savings to cover an additional 50,000 South Dakotans under Medicaid.

Trump hasn't set a clear policy position on Medicaid expansion but has said he'd repeal the Affordable Care Act, though two of his closest allies, New Jersey Gov. Chris Christie and Indiana Gov. Mike Pence, have accepted Medicaid expansion.

For the record: South Dakota voted for Trump 62% to 32%, around 228,000 to 117,000 people. I've no idea how many of those 228,000 Trump supporters would have qualified for Medicaid under the ACA, but they just screwed themselves. "Bigly".

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