House sends Medicaid work requirement ballot measure to Senate

A resolution that would put Medicaid back on the ballot in 2024 passed the House of Representatives and will head to the Senate.

The House passed HJR 5004 with a 60-8 vote. The resolution would ask South Dakota voters to amend the state constitution to let the state impose work requirements on “able-bodied” people eligible for expanded Medicaid.

South Dakota voters approved a constitutional amendment during the 2022 general election with a 56% majority to expand Medicaid eligibility. South Dakota is the 39th state to expand the program, which is a federal-state partnership providing health care insurance for low-income people.

Rep. Tony Venhuizen, R-Sioux Falls, and Sen. Casey Crabtree, R-Madison, proposed the joint resolution.

The resolution would add an exception to the voter-approved amendment, which currently prohibits the state from imposing “greater or additional burdens or restrictions” on eligibility. The exception says the state “may impose a work requirement on any person, eligible under this section, who is able-bodied.”

Representatives who opposed the resolution questioned what able-bodied would mean and cautioned against suggesting an amendment so recently after the voters approved Medicaid expansion. Rep. Linda Duba, D-Sioux Falls, said many of her constituents might be considered able-bodied, but don’t work for a variety of reasons.

“I spoke to so many mothers and fathers where one was staying home because they couldn’t afford to go to work and pay for child care,” Duba said. “Or they were not on insurance because they couldn’t afford it or their employer didn’t offer insurance. For these people, Medicaid expansion is critically important.”

Venhuizen said a work requirement is possible in other states, and the resolution would allow South Dakota to consider the same thing.

“If we pass this and put it on the ballots and then it passes, that’s where we come back in the future and say if this is the right thing for South Dakota,” Venhuizen said. “Those are things we can talk about at that point. This would remove the prohibition that prevents us from even having that conversation.”