South Dakota House stops proposal asking voters to repeal Medicaid expansion

Lawmakers in the state House of Representatives halted an effort to send a proposed repeal of expanded Medicaid to South Dakota voters.

The effort would have placed a state constitutional amendment on the general election ballot in November, reopening a policy debate from four years ago. But state representatives voted 39-27 against it on Thursday in Pierre.

Medicaid is a low-income health insurance and disability assistance program, jointly funded by the federal government and the states. South Dakotans approved a 2022 ballot question that expanded eligibility to adults with incomes up to 138% of the poverty level. Because the expansion is part of the state constitution, it can only be altered by voters.

While transitioning to expanded Medicaid has been a “long process” and a “forecasting nightmare,” said Rep. Chris Kassin, R-Vermillion, Medicaid expansion costs are about 6% of the overall Medicaid budget. Enrollment in the program has plateaued at about 30,000 South Dakotans, said Kassin, who is a member of the legislative budget committee.

Lawmakers already placed a constitutional amendment on November’s ballot that would let the Legislature repeal expanded Medicaid if the federal government stops funding at least 90% of the program. Kassin worried two questions about Medicaid on the ballot would confuse voters.

Voters approved an effort in 2024 to authorize work requirements for expanded Medicaid as well. Congress later voted to implement work requirements, which will start in 2027.

Kassin defended those ballot questions.

“The distinction is that we aren’t subverting the will of the people with those ballot measures,” Kassin said. “All we’re doing is asking them to clarify what they voted on.”

Supporters of Thursday’s failed resolution said the rising costs of Medicaid in the state are diverting funds from other needs, such as state education funding.

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This article, “South Dakota House stops proposal asking voters to repeal Medicaid expansion,’” has been republished from the South Dakota Searchlight under Creative Commons license CC BY-NC-ND 4.0.