Press "Enter" to skip to content

Amendment D: Hospitals Get Medicaid Expansion on November Ballot

Yesterday Secretary of State Steve Barnett validated the hospital lobby’s Medicaid expansion initiative to appear on the November 8 general election ballot as Amendment D. Secretary Barnett reports that the hospitals’ petition circulators did a pretty good job of collecting valid voter signatures on their petition from July through the beginning of November:

  • Signatures submitted (reported by sponsors): 46,119
  • Estimated sample size: 722
  • Percent of sample found valid: 82.13%
  • Estimated number of valid signatures in sample: 593
  • Estimated number of valid signatures: 38,244
  • Calculated number of signatures submitted: 46,565.2
  • Calculated circulator error rate: 17.87%

The hospital lobby’s 2021 circulators outperformed 2019’s petitioners: error rates for the IM 26 and Amendment A cannabis petitions were 25.35% and 31.26%, respectively. In the past, error rates below 20% have generally resulted only from volunteer petition drives. My impression from the hospital lobby is that, as a large organization unfamiliar with and disinclined toward grassroots organizing, they hired out most of their circulating.

Secretary of State Barnett also appears to have increased the number of signatures required to get an amendment on the ballot by one. For the last two petition cycles, the SDSOS website has consistently reported the signature threshold to be 33,921. But yesterday’s press release says initiating an amendment requires 33,922 signatures, a number now amended on the website.

The signature threshold is supposed to be 10% of the votes cast for Governor in 2018. That year South Dakotans cast 339,214 votes for Kristi Noem, Billie Sutton, and one of the eleven people who believe Joe Boever jumped in front of Jason Ravnsborg’s car. Divide by ten, and the signature threshold is 33,921.4. Secretary Barnett rounded that figure down to 33,921 in 2020 when he validated the petition for Amendment A. Since then, Secretary Barnett has apparently decided that 33,921 is a hair under the constitutional 10% threshold and that 33,921.4 must thus be rounded up to 33,922.

Kristi Noem and other people who hate initiatives and Medicaid expansion have 30 days to challenge the Secretary’s signature count. But as we learned from the South Dakota Supreme Court at Thanksgiving, they have all the time in the world to challenge the petition in court and thwart the will of South Dakota’s voters, who, according to the most recent poll by the AARP and every poll I know of since President Barack Obama established Medicaid expansion, will very likely vote to pass Amendment D.

Now the hospitals can switch into campaign mode. The first step of that campaign needs to be a full-throated campaign to defeat Amendment C in June. Amendment C is the Republican Legislature‘s attempt to thwart Medicaid expansion and other practical reforms by increasing the vote required to pass ballot questions that spend money from simple majority to 60%.

I wonder which the hospitals will decide costs less: fighting an anti-democratic proposal that’s bad for all South Dakotans and for democracy and working to get out the non-Republican vote for a generally low-turnout and thus easily swingable June primary, or just coasting on strong poll numbers and doing a little extra advertising in the fall to get their single measure across the higher 60% threshold?


  1. larry kurtz 2022-01-04

    Bless their hearts. No doubt the Republican-glutted legislature will simply blow it up.

    Three hospitals in South Dakota operate as an oligopoly statewide and as monopolies in their own markets. Montana is pretty much the same: Benefis, Deaconess and the Billings Clinic operate as a virtual triopoly in that state, too. It’s disaster capitalism for oligarchs and religionists masquerading as health care. Senator Jon Tester (D-MT) has known about the monopolistic nature of rural hospitals for decades now red state Montana is seeing 1,200 people contracting the Trump Virus every day.

    According to WalletHub Montana is the the best state in the US for doctors and South Dakota has dropped to fourteenth.

    After Amtrak’s Empire Builder derailed near Joplin, Montana many of the injured passengers were unable to find medical care because area hospitals are overwhelmed with unvaccinated Republicans. The Benefis Health System hospital in Great Falls is about 100 miles from Joplin.

  2. Mark Anderson 2022-01-04

    With Republicans it’s if you can’t afford care, then die. They are increasing killing their own. They are in denial.

  3. Porter Lansing 2022-01-04

    Paid petition gatherers perform a vital service in the name of democracy.
    After all, paid petition gatherers are like ticket sellers.
    They don’t tell you whether to like the show or not like the show.
    They only give you a chance to make your voice heard.

  4. Cory Allen Heidelberger Post author | 2022-01-04

    We would have far less need of mercenary petition circulators if we could repeal all the bureaucracy and paperwork Republicans have piled onto the initiative and referendum process. Republicans either want to kill the process or make it the exclusive purview of wealthy interests.

  5. Porter Lansing 2022-01-04

    If If If … Medicaid expansion is far from a grass roots issue.
    – Have you seen the campaign against Amendment D being waged from Pat Powers and on up the greasy tree of the SDGOP?
    – By election day it’ll be personally supported by every communist in Cuba and anyone wanting to help lower income workers will be renamed “self-serving socialists”.

Comments are closed.