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)
RAPID CITY, S.D. (KOTA) – A free worship concert is coming to Rapid City this Friday night as part of the annual Homeschool South Dakota Conference.
The concert will take place May 15th at The Monument and will officially kick off the two-day conference event. Doors open at 7 p.m., with the concert beginning at 7:30.
The evening will feature praise and worship music from Mike Weaver, the lead singer of the Christian band Big Daddy Weave. Organizers say the concert is completely free and open to the public, no tickets or conference registration required.
The Homeschool South Dakota Conference brings together homeschooling families from across the state for educational sessions, guest speakers and community activities throughout the weekend.
Organizers say the concert is designed to be a community-wide event welcoming anyone interested in attending. Additional information about the conference and concert is available through Homeschool South Dakota.
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South Dakota knows how to slow down. Hot Springs runs an 87-degree natural mineral pool that has drawn visitors since 1890. Spearfish anchors itself with a working fish hatchery dating back to 1896. Mitchell rebuilds its Corn Palace exterior every year out of actual corn. These are six of the state’s most relaxing small towns.
Aberdeen
Aberdeen sits in the James River valley of northeastern South Dakota, known locally for being the closest thing the state has to an Oz theme park. Storybook Land, a free-admission public park on the north side of the city, is built around L. Frank Baum’s connection to the area. Baum lived and published in Aberdeen in the 1880s, and the park features a full Wizard of Oz land with a yellow brick road, the Emerald City, and Dorothy’s House. The same park complex includes a castle, fairy-tale attractions, and a small petting zoo.
Downtown, the Hagerty & Lloyd Historic District holds some of Aberdeen’s oldest homes and buildings, including the Margaret and Maurice Lamont House, a Tudor Revival. Richmond Lake Recreation Area, about 10 miles northwest of town, adds hiking, biking, and camping on a reservoir that is the local summer anchor.
Hot Springs
Relaxation is built into Hot Springs. You can soak in the warm natural waters of the Evans Plunge Mineral Springs, which have drawn visitors for over a century. Established in 1890, the spring-fed waters naturally hold a year-round 87-degree temperature. In addition to the thermal springs at Evans Plunge, you have hot tubs, steam rooms, slides, and more.
Beyond the soak, the Mammoth Site is an active paleontological dig featuring remains of Ice Age giants. Consider booking a stay at the historic Red Rock River Resort Hotel & Spa, a sandstone building constructed in 1891. Family-owned and located downtown, the hotel offers quality care and a well-preserved interior. It’s within walking distance of Evans Plunge and other hot spring locations.
Lead
A close neighbor to the busier Deadwood, Lead is a town every bit as historic and far more relaxing. It’s an old mining town at its core, with several modern amenities along its historic Main Street. The Black Hills Mining Museum showcases the area’s gold rush, while the Homestake Opera House, which hosts year-round tours, concerts, dances, and educational events, is a century-old building that once held a bowling alley, billiards hall, and more.
For families, the Sanford Lab Homestake Visitor Center takes a deep dive into the region’s history, its people, and the ongoing scientific research conducted in its underground laboratories. Lead is the right town for South Dakota’s Wild West history without the commercial trappings.
Spearfish
On the northern edge of the Black Hills, Spearfish sits at the mouth of Spearfish Canyon, a 19-mile limestone gorge cut by Spearfish Creek that drops several notable waterfalls along its length. The Spearfish Canyon Scenic Byway follows the canyon floor, past Bridal Veil Falls and Roughlock Falls, and provides one of the most reliably beautiful and uncrowded drives in the state. The D.C. Booth Historic National Fish Hatchery, established in 1896 and now run as a historic site, anchors the town’s history with restored buildings, raceway ponds full of visible trout, and the Von Bayer Museum of Fish Culture.
Downtown Spearfish has a walkable core along Main Street with local restaurants including Killian’s Food and Drink and Lucky’s 13 Pub. For shorter outings, Spearfish City Park features the hatchery at one end, a sculpture walk along the creek, and shaded picnic grounds. Combined with its easy access to Deadwood, Lead, and the rest of the northern Black Hills, Spearfish offers a strong base for anyone wanting to relax without giving up access to outdoor activities.
Custer
Custer is the gateway to Custer State Park, a 71,000-acre preserve in the southern Black Hills that holds one of the largest publicly owned bison herds in the country, roughly 1,300 head, along with elk, pronghorn, and mule deer. The Wildlife Loop Road runs 18 miles through open grassland and mixed pine, with frequent wildlife sightings. Jewel Cave National Monument, 15 miles west of town, has more than 215 mapped miles of passages, ranking it among the longest cave systems in the world.
Downtown Custer itself is compact, with Sage Creek Grille serving elk-stuffed mushrooms and other regional dishes; it has been a fixture on Mount Rushmore Road for two decades. The Crazy Horse Memorial, still under construction since 1948, sits 15 miles north on Highway 385. For outdoor activity, Custer is the closest town to both the 109-mile Mickelson rail-trail and the trailhead for Black Elk Peak, the highest point in South Dakota at 7,242 feet.
Mitchell
Mitchell is home to the Corn Palace, a civic auditorium on Main Street whose exterior is redesigned every year out of actual corn, grain, and native grasses by a rotating group of local artists. The original structure dates to 1892, with the current building completed in 1921. New murals go up each summer. The building hosts high school basketball, concerts, and the annual Corn Palace Festival in late August. Admission is free year-round.
Woolworth’s Caramel Apples, next door, has been making the same recipe since the 1950s. The Dakota Discovery Museum a few blocks away covers regional history with a restored 1886 one-room schoolhouse, 1900 farmhouse, and 1909 Italianate home, plus a collection of Native American art and early 20th-century prairie paintings by Oscar Howe and Harvey Dunn.
Visit Relaxing South Dakota Today
These six towns split fairly cleanly between two South Dakotas: the prairie side, Aberdeen and Mitchell, and the Black Hills side, Hot Springs, Lead, Spearfish, and Custer. The prairie towns are anchored by one or two strong local institutions and a quieter pace. The Black Hills towns are anchored by the landscape itself. Either side rewards a weekend, and together they give you a fuller picture of the state than Mount Rushmore alone ever could.
The state Teacher Apprenticeship Pathway has both increased its cohort size and endowed about 50 new teachers. Advocates say in a state with a noted teacher shortage, it represents steps toward closing the gap for educators.
The pathway gives qualified and interested paraprofessionals the opportunity to advance their careers and become fully fledged teachers.
For Kathryn Blaha, state Department of Education Division of Accreditation director, it does make a difference in the lives of those involved, and the communities they serve.
“As I listen to people who have been accepted into the program and hear their stories, it’s an opportunity for them to make a difference at a different level in the classroom, but it’s also making a significant impact on the communities that they’re living in and the financial changes for their own personal children,” Blaha said.
These cohorts are expanding to provide more opportunities on the back of support from the governor.
“We’ve had state support for additional funding for the program,” Blaha said. “It really is a program that allows individuals who otherwise may not have had an opportunity to seek a position as a teacher in a classroom to gain the experience and training to do so.”
As a result, Blaha said the new cohort will have over 70 positions. That’s the largest group since the inception of the program in 2023.
“It’s been a tremendous program,” Blaha said. “We have 118 that have graduated as of the spring and summer 2026 graduation ceremonies. We’re really to the impact and the differences those individuals will make.”
The program is run through Northern State University and takes an average of two years to complete.
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