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South Dakota Voters Said Yes to Health Care. Amendment I Would Say No.
Health Care Coverage for 30,000 South Dakotans is on the Line
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South Dakotans voted in 2022 to protect health care for working people. Amendment I, which is on the November ballot, could reverse that decision and put coverage at risk for more than 30,000 South Dakotans.
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What Amendment I Would Do to Medicaid Coverage in South Dakota
Four years ago, South Dakotans made a clear choice. Voters approved Medicaid expansion because they believe hard-working people should not have to go without health care simply because they earn too much to qualify for traditional Medicaid but not enough to afford private insurance. That decision helped tens of thousands of South Dakotans gain access to doctor visits, prescription medications, preventive screenings and treatment for chronic conditions.
Amendment I, which is on the November ballot, threatens to undo that progress.
AARP South Dakota
"Supporters may try to frame Amendment I as a budget measure, but the reality is much simpler,” said Erik Gaikowski, State Director of AARP South Dakota. "If passed, the amendment could automatically end Medicaid expansion in South Dakota if the federal matching rate falls below 90%, putting health coverage for more than 30,000 South Dakotans at risk.”
That single threshold could trigger an all-or-nothing outcome, automatically eliminating coverage for thousands of South Dakotans who rely on it today.
Who Would Lose Health Care Coverage if Amendment I Passes
The 30,000 South Dakotans who benefit from Medicaid expansion are not statistics. They are neighbors, relatives, coworkers and friends.
"They are South Dakotans working in childcare centers, grocery stores, retail businesses, construction sites, farms, ranches, restaurants and countless other occupations that often do not provide health insurance,” Gaikowski said. "Many are family caregivers who spend hours each week caring for aging parents, spouses or loved ones with chronic illnesses while also holding down jobs of their own.”
People in South Dakota with low incomes who work hard every day should not have to choose between medical care and the basics they need to get by. As Gaikowski put it, “Health care coverage helps people stay in the workforce, avoid crushing medical debt and remain active members of their communities.”
What Health Coverage Means for South Dakotans Ages 50 to 64
For South Dakotans between the ages of 50 and 64, access to health care is especially critical. Many people in this age group face growing health challenges while not yet qualifying for Medicare. They may be managing diabetes, heart disease, cancer, arthritis or other chronic conditions. Many are also serving as family caregivers, sometimes at the expense of their own health and finances.
“Taking away health coverage does not make those challenges disappear. It makes them worse,” Gaikowski said.
When South Dakotans have access to preventive care and treatment, they are more likely to manage chronic conditions before those conditions become emergencies. Coverage allows someone to fill a prescription before a condition worsens. It makes it possible to schedule a screening that catches a disease early, when treatment is most effective. Without coverage, too many people in South Dakota delay care until a health concern becomes a crisis. That outcome is devastating for families and far more costly for the health care system overall.
What Amendment I Means for Rural and Tribal Communities in South Dakota
For people in rural and tribal communities across South Dakota, the stakes are especially high. Karla Abbott is a retired nurse, nurse educator and enrolled member of the Cheyenne River Sioux Tribe. She knows firsthand what losing access to coverage would mean.
AARP South Dakota
“For many South Dakotans, especially those in tribal and rural communities, health care is already difficult to access. We know what it means to travel long distances for a doctor's appointment, a specialist visit, cancer treatment or emergency care,” Abbott said. “This issue is especially important for Native American communities, where health disparities remain significant and access to care can be difficult. Too many families already face barriers related to transportation, provider shortages and the distance between where they live and where care is available. Taking away health coverage would only make things worse.”
Medicaid expansion also supports the health care infrastructure that rural communities across South Dakota depend on. When more people have coverage, hospitals and clinics receive payment for the care they provide. That financial stability helps keep local facilities open for everyone, not only Medicaid recipients. Strong rural hospitals are essential to the health and economic vitality of communities throughout the state.
Take Action: Vote No on Amendment I
South Dakotans have already spoken on this issue. Voters approved Medicaid expansion in 2022 because hard-working people deserve access to health care and families should not have to choose between seeing a doctor and paying for groceries, gas or rent. Amendment I would disregard that decision.
AARP South Dakota urges every voter to protect the health coverage South Dakotans already chose. Vote NO on Amendment I on November 3.
Your voice makes a difference. Pledge to be a voter on November 3!
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