South Dakota Amendment I Sparks Debate Ahead of Election

As South Dakota voters prepare for the November 3 election, a constitutional question regarding Medicaid expansion is taking center stage in state politics. The legislative-referred measure, known as Amendment I, asks the electorate whether to repeal the state’s expanded Medicaid eligibility requirement if federal funding drops below 90%.

The ballot measure has sparked debate over both state fiscal responsibility and healthcare access for low-income residents. The discussion highlights a policy dispute about how future state legislatures might handle federal healthcare matching funds in the Mount Rushmore State.

Amendment I Details and Legal Interpretation

To take advantage of a federal funding match provided by the Affordable Care Act under the Obama administration, South Dakota voters chose in 2022 to extend Medicaid access to adults earning up to 138% of the poverty threshold. Because this expansion is part of the state constitution, it can only be altered by voters.

According to figures released by the state Department of Social Services in August, roughly 143,000 residents of South Dakota participated in Medicaid, with 31,000 of those individuals gaining coverage via the expanded eligibility criteria. Amendment I would change this framework by allowing the repeal of the constitutional expansion requirement if the federal government’s share of funding falls below 90%.

Disagreements persist over whether the amendment would automatically cancel expanded Medicaid if federal support decreases, or if it would simply provide lawmakers the authority to evaluate removing the expansion should federal backing drop.

Arguments For and Against the Repeal

Supporters of Amendment I argue that the measure is fiscally responsible. State Representative Will Mortenson, R-Fort Pierre, defended the proposal by emphasizing fiscal responsibility.

Photo: yahoo.com

Conversely, opponents warn that it could leave thousands of people without health insurance. Deb Fischer-Clemens, a nurse and Democratic former state lawmaker, expressed concern that the measure threatens coverage.

The debate over Amendment I is one of four proposed constitutional amendments placed on the ballot by the Legislature for the November 3 election. As voters weigh their options, state officials continue to field questions regarding the exact legal ramifications should federal healthcare matching rates fluctuate in the future.

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