Two former legislators—one Republican, one Democratic—who now lobby for South Dakota’s health care sector say the Legislature should get the message from the failure of Amendment I that voters are happy with Medicaid expansion:
In 2022, South Dakota voters approved expanding Medicaid eligibility to low-income adults with the federal government paying for 90% of the program and the state paying the remaining 10%. Amendment I would have repealed the expansion requirement if the federal government reduced its funding share.
…“I think it shows that a majority of South Dakotans supported Medicaid expansion in the past and still do, and just don’t want to mess with it,” said Tim Rave, a Republican former legislator who’s now president and CEO of the South Dakota Association of Healthcare Organizations.
…Deb Fischer-Clemens, president of the South Dakota Nurses Association and a Democratic former legislator, led the opposition group No on I. She’s “hopeful that the message is clear and that we aren’t going to have to deal with this again.”
“I just hope that they move on,” she said of lawmakers. “Other than that, we’ll be watching. We will be watching and paying attention and listening” [Meghan O’Brien, “Medicaid Expansion Supporter Hopes Lawmakers ‘Move On’ After Latest Ballot Fight,” South Dakota Searchlight, 2026.11.08].
The main Republican argument for Amendment I was that if the feds stopped supporting Medicaid expansion, South Dakota would be left holding a very expensive bag. South Dakotans can thank the rest of the country for mooting that argument by electing a Democratic Congress that will block any attempt by Trump to cut Medicaid and will instead spend the next two years working to repair all the damage Republicans have done to our health care safety net.