South Dakota
Report identifies factors leading to high child Medicaid disenrollment in SD
A new report underscores the percentage of South Dakota disenrolled from Medicaid coverage due to the public health emergency unwinding.
Researchers with the Urban Institute point to three policies that led to the large decrease.
States with high Medicaid disenrollment rates — like South Dakota — also saw high child disenrollment. Last year, the federal government reported a 27 percent in Medicaid enrollment for South Dakota kids.
A new report, created in conjunction with the Robert Wood Johnson Foundation, points to three state policy decisions contributing to those high rates.
“South Dakota is a good illustration of basically all of the things we highlighted in that paper,” said Matthew Buettgens, a senior fellow at the Urban Institute and one of the researchers who compared Medicaid enrollment data with projections.
Buettgens said states that took less than 12 months to disenroll Medicaid applicants had higher disenrollment.
States that prioritized and identified people likely to be ineligible also saw higher child disenrollment.
The Center for Medicaid and Medicare Services allowed states to apply for over a dozen waivers to streamline the unwinding process and reduce the number of people who are unnecessarily disenrolled. Of those fifteen waivers, the state only applied for one.
“That certainly is contributing to the high child disenrollment,” Buettgens said. “It’s not at all clear that that’s the entire story. Because the child disenrollment is so high, there very well may be something else going on.”
The rate of child disenrollment from Medicaid in South Dakota alarmed federal officials last year. US Health and Human services sent a letter to the Noem administration urging it to adopt policies to make Medicaid renewal easier.
In January, state officials attributed the drop in child Medicaid coverage to rising incomes and said they’re following federal guidance for disenrolling children.
In a statement, DSS Secretary Matt Althoff said the department followed all federal guidance during unwinding. He adds all renewals are examined based on eligibility requirements set forth in the state Medicaid plan, which was approved by the feds.
South Dakota Department of Social Services Secretary Matt Althoff full statement:
The South Dakota Department of Social Services has followed all federal guidance during unwinding. All renewals have been examined based on the eligibility requirements set forth in the state’s Medicaid plan, which has been reviewed and approved by the federal government. DSS is confident in the results from our unwinding efforts.
Regarding the UI report, South Dakota is called out in this report based on projections that the study authors alone created. In fact, the report itself acknowledges that state-specific economic factors and employment rates can cause Medicaid enrollment to deviate from their projected trends (second paragraph under limitations, pdf page 14). UI’s analysis is based on estimates of past enrollment trends in their Health Insurance Policy Simulation Model (HIPSM) which they used to project a future enrollment rate. But the study author’s note that for smaller states, there is greater uncertainty in those projections. DSS also notes the study’s acknowledgment that increased economic growth in a state reduces its Medicaid enrollment (UI report executive summary).
DSS offers essential context in which to review Unwinding data for South Dakota:
- Medicaid and CHIP enrollment in South Dakota were steadily declining prior to the start of the public health emergency.
- The policies mentioned in the UI report are not part of the state Medicaid Plan
- South Dakota’s Plan for Unwinding, which was approved by CMS, projected enrollment rates to decline and trend toward pre-pandemic levels. Indeed, this is precisely what occurred.
- The percentage of children enrolled in South Dakota Medicaid declined by 0.32% per year between 2020 and 2023, comparable to the previous two years decline of 0.30% per year.
- South Dakota concurrently experienced declining numbers for SNAP, TANF and CCA (Child Care Assistance) over the same time period measured in the UI report.
- South Dakota had the 4th lowest rate of procedural closures (for administrative rather than income basis) in the nation. (KFF Health News tracker)
See Republican Zach Lahn speak after primary win in governor’s race
GOP gubernatorial candidate Zach Lahn speaks to his supporters during an election night watch party on June 2, 2026, in West Des Moines.
The makeup of the Legislature was up in the air as of 1 a.m. after South Dakota’s primary election.
Ten Republican state lawmakers ousted in 2024 are angling to get their seats back in 2026. Results were mixed for the nine who had primaries on Tuesday, with results still coming in for several races and others set for possible recounts.
Shawn Bordeaux of Rosebud won the state’s only Democratic primary, beating Troy “Luke” Lunderman for a chance to return to the state Senate.
Bordeaux will face Chamberlain Republican Rebecca Reimer in November’s general election. Reimer, who was term-limited in the state House of Representatives, beat Lower Brule Sen. Tamara Grove in Tuesday’s primary.
In Watertown’s District 5, Rep. Josephine Garcia fell in a state Senate primary to incumbent Sen. Glen Vilhauer. Garcia beat Byron Callies in the 2024 primary to earn her seat in the House of Representatives, but opted to challenge Vilhauer for his Senate seat instead of seeking reelection to the House.
Callies, Vilhauer and Garcia are all from Watertown.
Vilhauer won with 59% of the vote. His was one of the first state legislative victories of the night reported on the Secretary of State’s website.
Vilhauer won handily, but he said he wasn’t necessarily expecting to as polls opened on Tuesday.
“I knew it was going to be a battle going in,” Vilhauer said. “She worked hard on her side, and I didn’t know what to expect.”
Callies was among the first to call Vilhauer to congratulate him, around 9:30 p.m.
“I’m happy, because Glen’s a solid legislator,” said Callies, who’s angling to win his seat back in the general election.
Garcia did not return a call seeking comment.
In District 21, Sen. Mykala Voita of Bonesteel beat former Sen. Erin Tobin of Winner in a rematch of their 2024 contest, which Voita won by a few dozen votes that year. This time around, Voita bested Tobin by 1,002 votes.
In response to a request for comment, Voita sent a text reading “Glory to God!”
Tobin did not return a call from South Dakota Searchlight about her race after it was called, but said earlier in the evening she would be “at peace” with the results regardless of what they might be.
Another rematch saw Yanktonites Lauren Nelson and Jean Hunhoff battling for District 18’s state Senate seat. Nelson was a newcomer in 2024 when she beat Hunhoff, who’d spent decades in the Capitol between stints in the House and Senate. On Tuesday, Nelson held off Hunhoff, winning by 243 votes.
Other notable races
- District 4 Rep. Dylan Jordan of Clear Lake, first elected in 2024, finished fourth in a five-way race. As of 1 a.m. Wednesday, he trailed Ryan Kohl of Milbank and former Rep. Fred Deutsch of Florence, in first and second place, respectively. A recount is possible in that race, with 59 votes separating the top two vote-getters while Rep. Kent Roe, of Hayti, came in third place, with 72 fewer votes than Deutsch.
- District 4 has two possible recounts. In the other, Bryant’s Stephanie Sauder beat Clear Lake’s Tim Begalka by 105 votes in the unofficial tally from the Secretary of State.
- District 1 Rep. Logan Manhart of Aberdeen, elected in the 2024 primary, fell to Rep. Nick Fosness, a hospital administrator appointed by Gov. Larry Rhoden in 2025, and newcomer Daniel Kjos.
- Another recount was possible as of Wednesday at 1 a.m., in the District 16 race for House of Representatives. Rep. John Shubeck of Beresford trailed Lisa Bogue of Beresford by 245 votes in unofficial results. Jason VanDenTop of Canton was in third place, trailing Shubeck by 68 votes.
Vote totals incomplete
- Sen. John Carley of Piedmont, who won his first term in 2024, trailed William Meirose of Sturgis by 166 votes as of 1 a.m. Wednesday.
- Former Rep. Tyler Tordsen led Rep. Tony Kayser by two votes in the District 14 primary, with results still coming in. The Sioux Falls men are vying for second place and a spot on the November general election ballot alongside Rep. Taylor Rehfeldt of Sioux Falls, who led by more than 600 votes early Wednesday.
- District 28 Sen. Sam Marty of Prairie City was in a close race with former legislator Ryan Maher of Isabel.
- Former Rep. Gary Cammack of Union Center, who lost his seat in 2024, and Gary Deering of Hereford, led Reps. Terri Jorgenson of Piedmont and Kathy Rice of Blackhawk in the District 29 race.
- In District 30, Hot Springs Sen. Amber Hulse led former Sen. Julie Frye-Mueller of Rapid City by more than 1,300 votes.
- Former Sen. David Johnson of Rapid City led Sen. Curt Voight of Rapid City in a rematch of their 2024 race for District 33 Senate in early results.
- Rep. Heather Baxter of Rapid City has signaled her intention to challenge sitting Secretary of State Monae Johnson for the Republican nomination to that constitutional office at the state’s Republican Party convention this summer. In early results, Baxter trailed former Rapid City Rep. Becky Drury and Rep. Mike Derby in the District 34 primary.
- Early results in the District 35 primary put Sen. Greg Blanc, elected in 2024, in a close race with fellow Rapid City resident Nicole Mitzel.
South Dakota Searchlight is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.
South Dakota
Republican businessman Toby Doeden advances to primary runoff in South Dakota governor’s race
Republican businessman Toby Doeden has advanced to a runoff in South Dakota governor’s race, NBC News projects.
Gov. Larry Rhoden, who replaced Kristi Noem last year when President Donald Trump nominated her to lead the Department of Homeland Security, was battling with Rep. Dusty Johnson and former state House Speaker Jon Hansen for a second spot in the July 28 runoff. The primary will go to a runoff because no candidate eclipsed 35% of the vote.
Trump did not issue an endorsement in the race. Doeden branded himself on his campaign website as “a total political outsider who’s tired of the government’s failure to deliver on its promises” and one of Trump’s “fiercest supporters.”
Rhoden, a former lieutenant governor, agriculture secretary and lawmaker, campaigned on property tax cuts and lowering crime in his bid for a four-year term.
Johnson is the state’s lone representative in the House, where he previously was chair of the Republican Main Street Caucus. Hansen, who was elected to the South Dakota House in 2010, held several leadership positions before he became speaker.
The Republican nominee will be the favorite to win the general election in the solidly red state this fall. A Democrat has not served as governor in South Dakota since the 1970s, and Trump carried the state by 29 points in 2024.
News
Agronomist: eastern South Dakota crops hit and miss
An agronomist in eastern South Dakota says corn and soybeans are hit and miss as the growing season begins.
Steven Zemlicka with AgTegra Cooperative tells Brownfield, “We’ve got corn anywhere from V1 all the way up to V4. Biggest stuff’s maybe touching V5. Corn’s coming right along, looks pretty good. A little bit of hail here too, but I don’t think it’s going to be much of an issue. Stands for the most part are pretty good, pretty solid.”
Zemlicka says soybean emergence has been slow due to the wet, cool conditions, and there are a few fields that still need planted.
“People were still working on planting soybeans when we got the recent rain.”
He says recent rain totals ranged from a half inch to as much as four inches in the northeast part of South Dakota; the southern part of the state has been drier.
South Dakota’s corn is rated 61 percent good to excellent, with soybean conditions rated 57 percent good to excellent, according to USDA’s first condition ratings of the season.
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