AP

South Dakota approves Medicaid expansion over GOP resistance

Nov 8, 2022, 4:49 PM | Updated: Nov 9, 2022, 7:27 am

SIOUX FALLS, S.D. (AP) — South Dakota voters on Tuesday approved the expansion of Medicaid health insurance to tens of thousands of low-income residents through a constitutional amendment.

The majority vote to support Constitutional Amendment D removes South Dakota from a list of 12 states that have not expanded eligibility for the government health insurance program to people earning up to 138% of the federal poverty level — currently about $18,800 for an individual or $38,300 for a family of four.

The Republican-controlled Legislature had declined to expand Medicaid eligibility under the 2010 federal Affordable Care Act, and Gov. Kristi Noem has opposed the idea. But proponents for expansion have found success through ballot measures across GOP-dominated states, and a wide coalition of health care groups and organizations backed a well-funded ballot campaign this year in South Dakota.

“We’re a farm community, and people just can’t afford insurance so they need some more help,” said Bob Pederson, a Sioux Falls retiree who voted to expand eligibility Tuesday.

Dave Melemseter, also voting in Sioux Falls, said he backed expansion even though he worried it would weigh heavily on the state budget. Melemseter — who like Pederson said he usually votes Republican — said it was important for people to have coverage.

“I think it will pass and I think six years down the road, we’re going to be stuck with a really big bill,” he said.

Once a proposition that was anathema to conservatives, its passage would be a sign of growing acceptance even in a deeply red state.

By amending the state Constitution, voters would also place Medicaid expansion outside the grasp of the Legislature. Roughly 40,000 people would become eligible for Medicaid.

“We’re glad that South Dakota voters saw that helping our neighbors get health care is the right thing to do,” Dave Kapaska, who led the American Heart Association’s campaign work, said in a statement.

A coalition of health care groups, including the state’s largest hospital systems, initiated the ballot campaign. It has also won support from organizations that range across the political spectrum, from the state Chamber of Commerce to the South Dakota Farmers Union, religious organizations and progressive groups.

Advocates for expansion say that Medicaid access would help low-income people who could be saddled with exorbitant hospital bills, while also allowing the state’s citizens to tap into over $1 billion in federal funds.

They have run ads that feature working-class people like farmers and hairstylists talking about their need for health care coverage.

The campaign has branded the amendment as a financial “deal” for South Dakota. The federal government pays 90% of costs under a 2021 federal COVID-19 relief package, so the state would receive $1.3 billion in federal funding over five years for expansion. The state’s share over that time would be $166.2 million, but would also result in $162.5 million in savings, according to the Legislature’s research division.

But some Republican lawmakers have argued that the constitutional amendment would create a liability in South Dakota’s small state budget.

Groups like American for Prosperity, a free-market lobbying organization, also argue that Medicaid is a wasteful program and discourages people from seeking jobs where they can get private insurance.

In an effort to head off the Medicaid expansion vote, Republican lawmakers had proposed a separate constitutional amendment in this year’s primary election that would have required a 60% vote threshold on ballot measures that raise taxes or spend significant government funds. That proposal was overwhelmingly rejected by voters.

Noem, who is likely to win the governor’s post again, opposed expansion but had said she would implement it if it passed.

___

Follow the AP’s coverage of the midterm elections at https://apnews.com/hub/2022-midterm-elections and check out https://apnews.com/hub/explaining-the-elections to learn more about the issues and factors at play.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

AP

Image: A Boeing 737 Max 7 is displayed during a debut for employees and media of the new jet in Ren...

Associated Press

Boeing says it’s in talks to buy Spirit AeroSystems, key supplier on troubled 737 Max

Boeing said Friday that it is in preliminary talks to buy Spirit AeroSystems, which builds fuselages for Boeing 737 Max jetliners.

4 hours ago

Image: McKenna Shuster works on a linocut art print which she does as a hobby in her home on the la...

Mike Stobbs, The Associated Press

U.S. health officials drop 5-day isolation time for COVID-19

Americans who test positive for COVID-19 no longer need to stay in isolation for five days, U.S. health officials announced Friday.

9 hours ago

Image: Republican presidential candidate former President Donald Trump speaks at a Get Out The Vote...

Associated Press

Supreme Court agrees to decide if Trump can be prosecuted for election interference

The Supreme Court has agreed to decide whether the former president can be prosecuted on charges he interfered with the 2020 election.

2 days ago

mcconnell...

Michael Tackett, The Associated Press

McConnell will step down as the Senate Republican leader in November

McConnell said he plans to serve out his Senate term, which ends in January 2027, “albeit from a different seat in the chamber.”

2 days ago

Image: This combo image shows President Joe Biden, left, on Jan. 5, 2024, and Republican presidenti...

Associated Press

Trump, Biden won Michigan: but ‘uncommitted’ votes stick out

Early results from Michigan highlighted some of the two candidates' biggest political vulnerabilities ahead of the November general election.

3 days ago

An entrance to a Macy's store in the mall. (File photo: Ted Shaffrey, AP)...

Associated Press

Macy’s to close 150 stores as sales slip, pivot to luxury with Bloomingdale’s locations

Macy’s will close 150 unproductive namesake stores over the next three years including 50 by year-end, the department store operator said Tuesday.

3 days ago

South Dakota approves Medicaid expansion over GOP resistance