South Dakota voters pass Medicaid expansion amendment

South Dakota will become the 39th state to implement a Medicaid expansion.
(Dakota News Now)
Published: Nov. 9, 2022 at 7:52 AM CST
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SIOUX FALLS, S.D. - Roughly 40,000 South Dakotans will be eligible for Medicaid, due to voters in the state passing Amendment D Tuesday night.

The measure amends the state constitution to expand access to the program for those at or below 138% of the federal poverty level. “South Dakotans Decide Healthcare” spearheaded the effort to say “Yes on Amendment D,” arguing in part that those who stood to benefit the most from the expansion would be lower-income workers currently without healthcare coverage.

The amendment had significant financial support from a number of business organizations, as well as the three major healthcare providers in the state.

On the flip side, opposition to expansion was limited, with minimal pushback coming in the final weeks. Opponents, like Americans for Prosperity, have argued that it would likely cost the state more than it was projected to and could negatively impact those with private insurance plans.

An effort to upend the Medicaid expansion vote before it was on the ballot failed during this year’s primary, when South Dakota voters soundly rejected Amendment C. That would have required a 60% vote threshold for ballot measures that raised taxes, or required spending a certain amount of government funds.

Now, the state will have to consider how to implement the program. According to the Affordable Care Act (ACA), states are responsible for paying for 10% of the program five years after implementation.

Medicaid expansion continues its streak of passing everywhere that is on the ballot. The closest that a race to expand Medicaid has ever been was in Oklahoma in 2020, where voters passed expansion by less than 1%.