South Dakota
Pace of Medicaid enrollment remains slower than expected – South Dakota Searchlight
Fewer people than expected are signing up for Medicaid through an expansion backed by voters in 2022, and the state Department of Social Services is adjusting its budget to reflect the slower pace.
That’s at least partially because the state hasn’t publicized the expansion. Most enrollees sign up when they have a medical issue and need coverage to help pay for it, DSS Deputy Secretary and Director of Operations Brenda Tidball-Zeltinger told the budget-setting Joint Appropriations Committee this week.
Medicaid expansion opened the subsidized health care program to people whose incomes sit at 138% of the federal poverty level or less, which is up to $41,400 for a family of four or $15,060 a year for a single person.
Enrollment for Medicaid expansion opened on July 1, 2023, after South Dakota voters approved the expansion in 2022.
The appropriations committee typically has one budget hearing for each state department during the regular legislative session. For DSS, the committee set aside a second meeting date explicitly to dive into Medicaid and Medicaid expansion.
Initially, state officials projected that about 57,530 people would be eligible for expanded services, Tidball-Zeltinger told the committee. But those figures were pulled from 2015 data, and assumed that all eligible residents would sign up.
“Now, as we examine and have a few months of data in terms of how many people have enrolled in the program, we’re really revising that,” Tidball-Zeltinger said.
At the end of December, she said, the state had 17,520 people on the expansion enrollment list.
Based on that slower uptake – enrollments have grown a little more than 26% each month for the last three months – Tidball-Zeltinger told lawmakers that about 40,000 people will have expanded coverage in 2025.
Those people are mostly adults without children, she told the committee. That group makes up 67% of the expansion population, the rest being parents. Sixty-five percent of enrollees also qualify for the Supplemental Nutrition Assistance Program, commonly referred to as food stamps.
Minimal outreach
Another figure offered during Monday’s meeting in Pierre caught the attention of lawmakers: 80%. That’s the number of newly enrolled Medicaid participants to have signed up with a medical claim.
“Oftentimes people come to us when they’ve got a health care issue, or they come to us through a provider as they’re seeing them,” Tidball-Zeltinger said.
Rep. Linda Duba, D-Sioux Falls, pressed the deputy secretary on why the agency hasn’t been more proactive in seeking out eligible adults.
“I can see billboards about vaccinations, and I can see billboards about STDs, but I have never seen any advertisements or any proactive community health workers that are out in communities as a result of DSS encouraging enrollment in those populations,” Duba said.
The department doesn’t intend to advertise, Tidball-Zeltinger said, but there are community organizations encouraging sign-up. The Community HealthCare Association of the Dakotas has worked to guide potential enrollees through the process.
The department sees providers as partners in sign-ups, as they are often the ones who suggest that coverage might be available when someone shows up seeking care.
“We have done a lot of stakeholder webinars and communication work with our partners,” Tidball-Zeltinger said.
Duba pointed to North Carolina to suggest that South Dakota could do more. She said she’d recently visited and saw ads encouraging sign-up.
Tidball-Zeltinger said that “some states took an approach very much like South Dakota,” which involved outreach to providers, while others used ad campaigns.
“It’s really a mix,” she said.
She also pointed to a chart in the DSS presentation that compared rates of Medicaid expansion take-up in states surrounding South Dakota. Some states, like Iowa, had faster uptake for Medicaid initially. Others saw rates similar to South Dakota. But all of them saw steadily increasing numbers during the first two years of expansion.
Adding around 2,000 people a month, Tidball-Zeltinger said, is “in the ballpark with what we’ve seen in other states that surround us.”
Duba suggested, however, that the DSS work to track how much the state pays per enrollee and separately report the cost for those who sign up when seeking care versus those who sign up beforehand.
Duba argued that the second group of enrollees is likely to be less expensive to cover in the long run.
“If we were more proactive, people would be using preventative services, instead of coming in when they’re sicker, or they’re in greater need, which drives our utilization costs up,” Duba said.
Budget adjustments
Lower enrollments have also had an impact on the DSS budget, at least for 2024 and 2025. The federal government covers 90% of the cost for Medicaid expansion, and South Dakota also gets 5% more per year in federal dollars until 2026 to help the state ease into the expansion.
Lawmakers set aside about $54 million in state money for the first year of expansion. The department needed $37.5 million less than that.
The department also revised its ask for 2025 downward by $16.4 million based on the lower enrollments.
South Dakota voters approved Medicaid expansion, but implementation may not be easy
Those budget revisions don’t signal savings, though. The department also set aside $11.4 million in “buy-down” dollars in 2024, and will ask to set aside another $18.3 million for 2025, in hopes of softening the budgetary blow when the 5% federal boost dries up in 2026.
Jason Simmons, the budget director for the DSS, told appropriators that the $29.7 million set aside over those two years still won’t be enough come 2026.
“That’s still going to leave $34.5 million that the state is going to have to come up with (for 2026) just to maintain that baseline level of services,” Simmons said. “Any additional enrollment, any provider inflation, anything we see added to Medicaid is going to make that number go up.”
The DSS, Bureau of Finance and Management and the Legislative Research Council worked to adjust projections after enrollments began. The revised projections are a sign that a work group that met last year to discuss Medicaid expansion did its job, according to Rep. Tony Venhuizen, R-Sioux Falls.
“This is a big area in our state budget with a lot of unknowns right now and a lot of future growth, and it’s going to take up a lot of ongoing revenue into the future,” Venhuizen said. “And I think we’ve done a very good job of working together to project this to the extent that we can and to plan for building it into our budget.”
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BURKE, S.D. – A Nebraska man who died in a single vehicle crash Tuesday evening, 10 miles east of Burke has been identified.
Preliminary crash information from the South Dakota Department of Public Safety indicates Roy Robert Cadwallader, 71, of Stuart, Nebraska, the driver of a 1939 Chevrolet JB Coupe, was traveling eastbound on Highway 18 when the vehicle left the roadway and entered the ditch. The vehicle struck an approach, went airborne, then rolled.
Cadwallander died at the scene.
The crash occurred at approximately 7:24 p.m. Tuesday, June 9 near mile marker 296, about 10 miles east of Burke in Gregory County. Seat belt use remains under investigation, according to the SDDPS.
The South Dakota Highway Patrol is investigating the crash. All information released so far is only preliminary. The Highway Patrol is an agency of the South Dakota Department of Public Safety.
Our newsroom occasionally reports stories under a byline of “Mitchell Republic.” Often, the “Mitchell Republic” byline is used when rewriting basic news briefs that originate from official sources, such as a city press release about a road closure, and which require little or no reporting. At times, this byline is used when a news story includes numerous authors or when the story is formed by aggregating previously reported news from various sources. If outside sources are used, it is noted within the story.
The South Dakota Lottery offers multiple draw games for those aiming to win big.
Here’s a look at June 13, 2026, results for each game:
Winning Powerball numbers from June 13 drawing
03-13-44-50-53, Powerball: 02, Power Play: 4
Check Powerball payouts and previous drawings here.
Winning Lotto America numbers from June 13 drawing
06-13-31-35-48, Star Ball: 07, ASB: 05
Check Lotto America payouts and previous drawings here.
Winning Dakota Cash numbers from June 13 drawing
04-10-18-28-30
Check Dakota Cash payouts and previous drawings here.
Winning Millionaire for Life numbers from June 13 drawing
03-05-11-13-49, Bonus: 01
Check Millionaire for Life payouts and previous drawings here.
Feeling lucky? Explore the latest lottery news & results
Are you a winner? Here’s how to claim your prize
- Prizes of $100 or less: Can be claimed at any South Dakota Lottery retailer.
- Prizes of $101 or more: Must be claimed from the Lottery. By mail, send a claim form and a signed winning ticket to the Lottery at 711 E. Wells Avenue, Pierre, SD 57501.
- Any jackpot-winning ticket for Dakota Cash or Lotto America, top prize-winning ticket for Lucky for Life, or for the second prizes for Powerball and Mega Millions must be presented in person at a Lottery office. A jackpot-winning Powerball or Mega Millions ticket must be presented in person at the Lottery office in Pierre.
When are the South Dakota Lottery drawings held?
- Powerball: 9:59 p.m. CT on Monday, Wednesday, and Saturday.
- Mega Millions: 10 p.m. CT on Tuesday and Friday.
- Lucky for Life: 9:38 p.m. CT daily.
- Lotto America: 9:15 p.m. CT on Monday, Wednesday and Saturday.
- Dakota Cash: 9 p.m. CT on Wednesday and Saturday.
- Millionaire for Life: 10:15 p.m. CT daily.
This results page was generated automatically using information from TinBu and a template written and reviewed by a South Dakota editor. You can send feedback using this form.
America is in a race, one that will define global economic leadership for the next decade. China is aggressively
positioning
itself as a center for artificial intelligence development and deployment. The winner will capture enormous competitive advantages in innovation, job creation and geopolitical influence. But there’s a detail often overlooked in this high-stakes competition. None of it happens without reliable critical infrastructure, such as power and data centers.
Winning the AI race is fundamentally about establishing the critical infrastructure that powers innovation. AI systems rely on data centers, and data centers require electricity. If the United States intends to remain competitive, we must be able to build and power that infrastructure efficiently and affordably. That requires thoughtful policy, modernized permitting and a clear commitment to growth.
Data centers are not secondary to the tech economy. They are the foundation. The nation that builds and controls the most advanced, reliable and affordable data center infrastructure will lead in AI development and deployment.
Here in South Dakota, we have the essential components to build this critical infrastructure. Our affordable energy, vast land and strong workforce create the necessary conditions for establishing data center facilities that can compete globally. Tech employment in our state has grown
17 percent
in recent years, outpacing many parts of the country. This is a signal that South Dakota can support and sustain the specialized environment required for advanced infrastructure development.
But having these advantages is not enough. The window of opportunity is finite, and other states are mobilizing their own competitive advantages. If we want South Dakota to be where America builds the critical infrastructure that powers the AI future, we must act decisively. Supporting and enabling this infrastructure development is not a favor to industry. It is imperative for our state and our nation.
Establishing critical data center infrastructure in South Dakota delivers immediate and long-term benefits for our communities. Big Watt alone currently contributes roughly $900,000 a year in kilowatt-hour taxes directly to local schools and could eventually provide more than $160 million annually as future phases come online. Its payroll already totals several million dollars a year, with nearly all staff drawn from within the region. This kind of investment can strengthen schools, support local businesses and create lasting economic opportunity.
Additionally, construction and development of this infrastructure alone can support hundreds of electricians, contractors, engineers and skilled trades workers. These are good-paying jobs that circulate dollars through local businesses. For rural parts of our state, that kind of investment can be transformative.
At Oahe Electric Cooperative, we see how thoughtful planning and load growth can support grid upgrades while protecting affordability for the families and small businesses we serve. We also know South Dakota is already a leader in renewable energy, with 29 wind projects totaling 3,476 megawatts, along with growing solar capacity and grid storage resources. As demand for electricity grows, we are taking on new generation responsibly through an all-of-the-above energy strategy that rests on a reliable foundation of natural gas and coal, accompanied by wind and solar resources. Just as importantly, data centers should be required to pay the upfront costs associated with their onboarding so existing consumers are not left subsidizing the infrastructure needed to support large-scale new load. When planned responsibly, this approach can support grid upgrades and new generation in ways that maintain reliability and protect affordability for South Dakota’s households and small businesses.
The broader significance is strategic. By establishing critical infrastructure for the technology economy, South Dakota positions itself as essential to American competitiveness. We attract complementary investment, develop specialized workforce expertise and build advantages that strengthen our state’s position in the global economy for decades. If our policies create uncertainty or make infrastructure development
financially unworkable
, capital will flow to other states where the path is clearer and the commitment is stronger. We must transform from a state watching the technology race to a state where the race is won.
Our state must act now to establish the critical infrastructure that will power American innovation for the next decade. This is our moment to position South Dakota as essential to winning the technology race. With practical regulations and a clear commitment to supporting data center infrastructure development, we can ensure that South Dakota is where America builds the advanced infrastructure that leads the world in artificial intelligence. The technology shaping the global economy will be powered by the infrastructure we build today. South Dakota can be that foundation.
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