Todd Epp spots research comparing Medicaid expansion in South Dakota and Georgia. South Dakota launched Medicaid expansion without a work requirement; Georgia imposed a work requirement.
The work requirement had its expected effect, reducing the number of people covered by Medicaid:
South Dakota’s traditional Medicaid expansion without work requirements resulted in significantly higher coverage gains than Georgia’s Pathways to Coverage program with mandatory work requirements during the first 15 months of implementation, according to a study published Monday in The BMJ.
The research compared Georgia’s approach with South Dakota, which expanded Medicaid on the same date — July 1, 2023 — but without imposing work mandates. Medicaid coverage increased in South Dakota from 36.6 percent to 44.6 percent among low-income adults, while Georgia’s coverage decreased from 35.5 percent to 32.4 percent, resulting in an 11.7 percentage point differential decrease in Georgia relative to South Dakota, according to the study [Todd Epp, “South Dakota’s Medicaid Expansion Significantly Outperformed Georgia’s Work Requirement Model, New Study Shows,” Northern Plains News, 2025.10.09].
The work requirements in Georgia also failed to produce more work, while South Dakota’s more generous Medicaid expansion appears not to have dampened our eagerness to work:
Neither Georgia nor South Dakota showed employment increases compared to control states, with no differential change in employment between the two states, challenging the premise that work requirements promote job participation, the researchers found [Epp, 2025.10.09].
King Donald’s national work requirement for Medicaid is coming, but this research requires us to ask, why? Work requirements don’t boost work; they only deny our neighbors health coverage and care.
Anyone hiring?
Other than attempting self employment, tough to get a job if nobody is hiring. Did those that put the work requirements in promise to provide jobs?
Republicans don’t care. They will do anything to sound like they are being sensible but deep down, they don’t believe health care is a right. If you can’t afford healthcare, just die. After all, a certain senator from Iowa, Joni Ernst earnestly pointed out, “we are all going to die”. Joni of course can afford to live.
Mark, I would add to your assessment that Republicans don’t see healthcare as a right — that they want to pay for. It is at the top of the selfish, non-Christian beliefs that conservatives value only their prosperity — often turning a bold eye to how tax/public funds are used to subsidize and enrich them.
When Republicans tout the value of work requirements, front and center to their rhetoric is the money requirements will save. Money can only be saved by covering fewer workers. Often that reduction in coverage is due to confusing or oppressive paperwork; people due the benefit – even under the work requirement – do not get what is deserved them.
All so billionaires can keep winning the economic redistribution war against the poor.
A collapse of the agriculture sector, $650 million plus cost overruns for a prison, $240 million plus cost overruns for the Platte-Winner Bridge rebuild, $150M plus cost overruns for a Capitol remodel and at least $2 billion for a boondoggle West River water pipeline but just a $65 million surplus, the end of property taxes and TIFs galore?
Looks like Earth hater pie-in-the-sky to any cynical observer.
How are 66 county seats and their bureaucracies either conservative or sustainable? They’re not; but, it is the way Republican cronyism and patronage built barricades to democracy by providing benefits of the public dole to those who say they deplore big gubmint in a state that hates poor people.
Since the bridge over the Missouri River between Fort Pierre and the cesspool on the east side was at least two years late and millions over budget maybe interim Governor Larry Rhoden should just apologize for decades of graft and a culture of corruption in South Dakota’s capital when he announces he isn’t running in the Earth hater gubernatorial primary.
Republicans are now using Reagan’s EMTALA to say Democrats want to give healthcare to illegals. Of course Vance wants them to not be admitted and die. The pro lifers are only pro life for Americans.
You know the work requirements would be good for those crypto lazy boy republicans.
Cruelty is the point.
SD’s whole Medicaid expansion could go away if voters approve Amendment I (that’s the letter i , not a number one or a letter L) next year. It would allow our state to drop Medicaid expansion altogether, if Congress ever ends or lowers its 90% share of Medicaid expansion cost. Individuals and healthcare facilities would be big time losers! But we all lose when our neighbors don’t have health coverage.
Be sure to help voters know to oppose AMDT I (That’s the letter i, as in “injustice.”) on the ballot next year. Maybe someone can think of a more catchy i-word to describe it.
Lyndon Johnson’s Great Society envisioned a war on poverty. Today’s government, both state and federal, are fighting a war on poor people and I’m afraid the government is winning. Sadly being poor sucks and our government only want it to suck even more.