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Health and Health Care

Expanded Medicaid conditions

A 2026 ballot measure would amend the South Dakota Constitution to condition the requirement of expanded Medicaid on the level of federal medical assistance. The measure puts the state’s Medicaid expansion commitment and dependence on federal matching funds before voters.

Should expanded Medicaid in South Dakota be conditioned on the level of federal medical assistance?

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Sources

South Dakota Secretary of State — https://sdsos.gov/elections-voting/upcoming-elections/general-information/2026%20Election%20Information/2026-ballot-questions.aspx
Title - An amendment to the Constitution of the State of South Dakota, conditioning the requirement of expanded Medicaid on the level of federal medical assistance.
Positions on this issue  ·  liberal → conservative
  1. Keep expanded Medicaid regardless of federal match changes
  2. Protect expansion but allow flexibility if federal funding drops sharply
  3. Undecided; study fiscal impact before constitutional change
  4. Yes—condition the expansion requirement on adequate federal assistance
  5. End or phase out Medicaid expansion and limit state health entitlements