Lawmakers aiming to pass bill giving voters the chance to change state’s Medicaid requirement

PIERRE, S.D. (Dakota News Now) – Wednesday’s Senate State Affairs committee listened to testimony on a bill that would propose a change in the state’s Medicaid expansion agreement if there are cuts made at the federal level.

As it stands today, the federal government covers 90% of Medicaid expansion coverage and the states cover the other 10%, but with the federal government making drastic cuts, South Dakota lawmakers want to have some options.

House Joint Resolution 5001 would end the state’s required Medicaid coverage the day the medical assistance percentage is reduced below 90%.

Lieutenant Governor Tony Venhuizen addressed those negating whether or not the federal government is interested in cuts to Medicaid.

“From what I’ve read and heard and even talking to our federal delegation, I would say there is a very real chance that there are cuts in the nature we are talking here today so I would not minimize that probability,” Venhuizen said.

Expanded Medicaid provides eligibility to nearly all adults with incomes up to 138% of the federal poverty level. If the federal government drops the percentage match, that will cost the state around $4 million for every percent dropped according to House Joint Resolution 5001’s Senate sponsor Casey Crabtree (R) Madison.

Roughly 21,000 South Dakotans are enrolled in expanded Medicaid which was first made available back in 2023, which is about 16% of total Medicaid enrollment in the state.

“But we’re going to cut, because we don’t want to invest in our own people, this immoral, we are talking about your constituents, we are talking about your neighbors,” Rev. Lauren Stanley said.

House Joint Resolution 5001 passed on a 7-1 vote.

Democrat Liz Larson, the only committee member to dissent, said the state can’t worry about the economic picture if people are slipping into poverty.

This resolution wouldn’t set any trigger laws and prevent the state from continuing enrollment in Medicaid expansion, however, if voters were to vote yes on the measure, it would give the legislature some options on how they want to pay for Medicaid expansion.

Venhuizen has previously noted that plans will heavily depend on how much the federal government drops their percentage of coverage.