Voters in South Dakota, which up until now was one of 12 states that had opted not to expand Medicaid, voted 56% to 44% to broaden Medicaid to roughly 42,500 low-income residents starting in mid-2023, the South Dakota Secretary of State data shows.
Amendment D, which will open up coverage to adults making less than roughly $19,000 a year, was endorsed by more than 60 organizations, including multiple healthcare and religious groups, the South Dakota Farmers Union, and the Greater Sioux Falls Chamber of Commerce.
This was the seventh successful initiative of the effort to expand Medicaid in Republican-led states – which began with the approval of Maine voters in 2017 – following the initiatives that passed in recent years in Nebraska, Utah, Oklahoma, Missouri, and Idaho.
Kelly Hall, executive director of The Fairness Project, which backed the measure, pointed out that South Dakotans deserve health care without the risk of going into debt or avoiding check-ups, and procedures, and skip buying the medication they need.
On top of that, the expansion would save South Dakota $162.5 million over five years as shown last year by the state’s Legislative Research Council.
Childless adults in South Dakota are currently not eligible for Medicaid while parents must have very low incomes – about $1,000 a month for a family of four – to qualify for Medicaid.
According to Zach Marcus, campaign manager for South Dakotans Decide Healthcare, which advocated for the ballot measure, the approved expansion will get South Dakota an additional $328 million in federal funds the first year and generate 4,000 new jobs.
Though she has said she will carry it out if voters approve it, South Dakota Republican Gov. Kristi Noem didn’t support the initiative and many Republican officials opposed it citing its potential future costs since states are responsible for picking up 10% of the health care tab of the expansion enrollees.
Earlier this year, an expansion bill failed in the South Dakota state Senate vote.
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