South Dakotans approve consideration of Medicaid expansion work requirements • South Dakota Searchlight

A ballot measure authorizing South Dakota state officials to consider work requirements for Medicaid expansion recipients was winning in unofficial results.

The tally was 56% in favor of Amendment F and 44% opposed as of 9:45 a.m. Central time Wednesday, with about 90% of statewide votes counted.

Medicaid is a federal-state health insurance program for people with low incomes. In the past, Medicaid was not available to able-bodied adults younger than 65, unless they were below the poverty line and had young children.

In 2022, South Dakota voters expanded Medicaid eligibility to adults with incomes up to 138% of the poverty level. The expansion is part of the state constitution and can only be altered by voters. It includes a ban on “greater or additional burdens or restrictions,” such as a work requirement.

Earlier this year, legislators decided to put Amendment F on the ballot. The amendment will allow lawmakers to consider a work requirement if the federal government permits it. The Democratic Biden administration does not allow it, but a future Republican administration might.

On Wednesday morning, the Vote No on Amendment F coalition, including several health-related organizations, predicted the measure may “place harmful government red tape around access to health care for thousands of South Dakotans.”

“Ensuring our neighbors get health care is the right thing to do and this result may inhibit that process,” said retired Yankton physician Mary Milroy, Vote No on Amendment F chair, in a statement. “Health care access for hardworking South Dakotans is good for them and their families, good for the employers who need them more than ever, and good for the economic progress of this state.”

She added that the measure could allow lawmakers and bureaucrats to write new rules governing Medicaid eligibility, and the measure “provides no specifics on what those rules will be nor how they will be enforced.”

At the polls Tuesday, Parker Stewart, a 38-year-old Sioux Falls resident, said he voted yes on the amendment. He counts himself as a supporter of Medicaid and Medicaid expansion, but sees a work requirement as a protective measure against abuse of the system.

“We have family members who are dependent on that program for medical reasons,” Stewart said. “But at the same time, there are those who take advantage of it.”

Jessica Aguilar, a 43-year-old from Sioux Falls, said she voted against the measure.

“Medicaid expansion was passed by South Dakotans last election,” she said. “Let it stand as it was passed.”