SJR 501: Venhuizen Revisits Work Requirement for Medicaid Expansion

Last updated on 2024-01-15

Representative Tony Venhuizen (R-13/Sioux Falls) has the first constitutional amendment in the 2024 Legislative hopper. Venhuizen is trying again to put before the voters a work requirement for enrollees in expanded Medicaid.

Venhuizen floated the work requirement in the 2023 Session, before the voter-approved Medicaid expansion was even enacted. Venhuizen’s 2023 amendment  would have inserted the following language (bolded) into the voter-approved amendment:

The State of South Dakota may not impose greater or additional burdens or restrictions on eligibility or enrollment standards, methodologies, or practices on any person eligible under this section than on any person otherwise eligible for Medicaid under South Dakota law, except that the State of South Dakota may impose a work requirement on any person, eligible under this section, who is able-bodied [2023 House Joint Resolution 5004, operative language bolded, filed 2023.01.22].

Venhuizen got that language through his House before Senate Health and Human Services squashed it after hearing from the health care providers who fought for Medicaid expansion in the first place.

Now the District 13 Representative and next Governor of South Dakota after Marty Jackley wants to take another swing at making expanded-Medicaid recipients roll out of their sick beds and clock in. Alas, the policymaker’s solution is to write longer policy in Senate Joint Resolution 501:

The State of South Dakota may not impose greater or additional burdens or restrictions on eligibility or enrollment standards, methodologies, or practices on any person eligible under this section than on any person otherwise eligible for Medicaid under South Dakota law, except that the State of South Dakota may, to the extent permitted by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, impose a work requirement on any person, eligible under this section, who has not been diagnosed as being physically or mentally disabled [2024 Senate Joint Resolution 501, operative language bolded, filed 2023.12.15].

Venhuizen also throws this resolution at the Senate first. He must figure his House members will still accede to his superior intellect (as the knuckle-dragging Republican supermajority generally ought), and so rather than waste their time, he’ll fight first to flip the upper chamber’s committee sentiment.

But he’ll still have to fight the health lobby, which recognizes that no matter how Venhuizen euphemizes able-bodied, the effect of his proposal would be to keep people from getting the care they need and that we the people can afford to provide:

Critics say the move it will burden businesses and working individuals.

Ben Hansen, the government relations director for the American Cancer Society in South Dakota, worries about Medicaid-eligible workers undergoing treatment for a cancer diagnosis—whether chemo or radiation.

“There are no carveouts or specifications for those undergoing treatments for terminal diseases. We don’t know what these work requirements look like,” Hansen said. “There’s just no point in putting unnecessary undue burden, adding to something that South Dakota voters clearly wanted” [Lee Strubinger, “Republican Lawmakers Want to Reintroduce Medicaid Work Requirement Question,” SDPB Radio, 2023.12.19].

Voters wanted Medicaid expansion, and it turns out the program is entirely affordable, not to mention good for South Dakotans. Why impose new complications on a program that’s working just fine, just as it has been for years in dozens of other states, with no fiscal or moral crisis arising?

Note that Representative Venhuizen is dodging a work requirement imposed on 900,000 other South Dakotans who might want to change the South Dakota Constitution. Regular folks have to circulate a petition and convince at least 35,017 voters to sign a petition to put an amendment on the general election ballot. Representative Venhuizen could have recognizes the Senate’s rebuff as a sign that he needed to take his case to the streets; instead, he’ll use his Legislative privilege again to seek the affirmation of 18 Senators and 35 other House members—just 53 people he needs to convince!—to call a statewide vote on his proposal to kick people back off Medicaid.