Lawmakers attempt to undermine voter-approved Medicaid expansion

PIERRE, SD – South Dakotans may find Medicaid on the ballot again in 2024.

The House State Affairs Committee passed a joint resolution Monday morning 11-2. It would ask South Dakota voters to amend the state constitution to let the state impose work requirements on “able-bodied” people eligible for expanded Medicaid.

South Dakota voters approved a constitutional amendment during the 2022 general election with a 56% majority to expand Medicaid eligibility. South Dakota is the 39th state to expand the program, which is a federal-state partnership providing health care insurance for low-income people.

Tony Venhuizen, R-Sioux Falls
 Rep. Tony Venhuizen, R-Sioux Falls 

Rep. Tony Venhuizen, R-Sioux Falls, and Sen. Casey Crabtree, R-Madison, proposed the joint resolution.

The resolution would add an exception to the voter-approved amendment, which currently prohibits the state from imposing “greater or additional burdens or restrictions” on eligibility. The exception says the state “may impose a work requirement on any person, eligible under this section, who is able-bodied.”

Opponents to the resolution included several health organizations, such as Avera and the American Lung Association, who worry that such an amendment would threaten access to health care for thousands of South Dakotans, add administrative costs to enforce reporting requirements laid out in the resolution, and make it difficult to define who is “able-bodied.”

Representatives with the American Lung Association and the Leukemia and Lymphoma Society submitted written opposition. It listed studies stating most Medicaid enrollees work unless they have a mental or physical condition interfering with their ability to work. Another study suggested Medicaid coverage made it easier for enrollees to find work.

Venhuizen addressed concerns during the committee meeting, saying the amendment does not mandate a work requirement.

“It doesn’t define every detail,” Venhuizen said. “It takes the prohibition out of the constitution so we can have this debate.”

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