A vote here sign, pictured on Nov. 8, 2022 at the All Souls Church on Cliff Avenue in Sioux Falls, South Dakota. (Josh Haiar/South Dakota Searchlight)
A solid majority of South Dakotans voted to expand eligibility for the state’s Medicaid programs Tuesday.
Constitutional Amendment D passed with 56% of the vote, or 191,781 votes, according to unofficial reporting from the Secretary of State’s Office.
“It’s long overdue,” said Rick Weiland, committee chair and treasurer for Dakotans for Health, which campaigned in favor of the amendment. “Sometimes you have to go directly to the people, and they know what they wanted.”
Now, the state government is setting a plan into action to make Medicaid available to 42,500 low-income South Dakotans ages 18 to 64 by July 1, 2023.
Medicaid expansion will cover such adults who earn up to 138% of the federal poverty level, or about $38,295 for a family of four, said Steve Long, public information officer for the Department of Social Services.
DSS expects around 52,000 newly eligible individuals will enroll, Long said in a written statement, “but those estimates have been exceeded in every other state that has expanded Medicaid.”
DSS has formed a leadership team to oversee implementation and its effects on operations. Long expects that a “significant number of additional staff” will be needed as well as policy and system changes, such as eligibility, claims processing, reporting and accounting.
The expansion will have an impact statewide, Weiland said, adding that the cost of uninsured South Dakotans seeking medical care gets passed onto people who have private insurance already through the overall cost of healthcare.
Zach Marcus, campaign manager of South Dakotans Decide Healthcare, said $328 million in federal taxes will stay in South Dakota because of expanded Medicaid programs, based on calculations from figures released by the Legislative Resource Council.
“That’s our money that we paid into taxes and aren’t receiving the benefit from,” Marcus said. “Those dollars stay here instead of going somewhere else.”
The coalition also estimated during its campaign that Medicaid expansion will generate $3.5 billion in new economic output by 2025, including $800 million by 2023.
“This huge coalition of organizations that came together to help pass this shows why this is going to be so good for South Dakota,” Marcus said. “There are so many groups that see this benefiting them and their organizations, and this will be such a good thing with all these people coming together behind it.”
South Dakota was one of 12 holdout states that implemented Medicaid expansion in the 2022 election since it was first effective in 2014.
After Medicaid expansion was discussed during the 2022 State Legislative season and failed, petitioners brought the issue to voters.
“If you know South Dakota well enough, we’ve had a lot of success when the Legislature fails to step up by going directly to the people,” Weiland said.
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