On Tuesday, November 8, South Dakota voters approved the expansion of access to the federal and state healthcare program known as Medicaid. With the support from citizens of South Dakota at polls, it became the seventh Republican-led state to expand Medicaid coverage through popular sovereignty. The measure passed with 56.2% support and now grants healthcare access to tens of thousands of low-income residents of South Dakota (The Hill, AP News). 

The expansion of Medicaid coverage was executed by passing an amendment (Constitutional Amendment D) to add to the state Constitution of South Dakota. For people earning up to 138% of the federal poverty level, Medicaid provides about $18,800 for one individual, as well as $38,300 for a four-person family (AP News). 

The campaign for expanding healthcare in South Dakota was well-funded this year, being initiated by a large coalition of healthcare organizations of varying political backgrounds. Religious organizations and progressive groups have also supported this cause, most notably, the state Chamber of Commerce and the South Dakota Farmers Union. The campaign also utilized advertisements to spread its message about the necessity of healthcare, showcasing working-class people, such as farmers or hairstylists, expressing their need for coverage. 

Although there is much support for expanding access to healthcare, there are many voices expressing their opposition to this development. For example, the South Dakota legislature, controlled by members of the Republican Party, had previously declined to expand Medicaid eligibility in February of 2022. Additionally, the Governor of South Dakota, Kristi Noem, opposed the idea of expanding access to healthcare. The line of reasoning many Republican lawmakers have expressed is that it would create a liability in South Dakota’s small state budget. Furthermore, organizations such as American for Prosperity argue that Medicaid is a wasteful program because it discourages people from finding careers that provide private insurance. 

However, the entire Republican Party is not in opposition to the expansion of healthcare coverage. A South Dakota citizen from Sioux Falls, Bob Pederson, voted on Tuesday for eligibility, saying that “We’re a farm community, and people just can’t afford insurance so they need some more help” (AP News). Some individuals that vote Republican, like Pederson, have expressed that they believe it is important for people to have coverage, while other Republicans still hold concerns for the state’s budget. However, throughout recent years there has been a growth in acceptance for promoting the expansion of healthcare in “Deep Red” states. For example, South Dakota Governor Kristi Noem has stated that although she opposes the expansion of healthcare access, she will implement it if it is passed. All in all, supporters are proud to have passed the Medicaid amendment in South Dakota as it will help more low-income people who may be dealing with exorbitant hospital bills, while also allowing the state’s citizens to utilize some of its 1 billion dollars in federal funds.