The South Dakota Senate has passed House Joint Resolution 5001 with an overwhelming 31-3 vote. The resolution proposes a constitutional amendment that would automatically terminate expanded Medicaid coverage if federal funding drops below 90 percent. The measure aims to provide financial protection for the state, as taxpayers would bear the burden of the 10 percent not covered by federal funds.
Sen. Casey Crabtree, R-Madison, the primary sponsor of the amendment, emphasized the importance of ensuring that South Dakota taxpayers are not left with a significant financial burden if federal funding decreases. However, not all senators were in agreement on the timeline for the proposed amendment. An attempt to move the question to the June 2026 primary ballot was rejected by a 14-19 vote.
Opposition to the resolution came from Sen. Liz Larson, D-Sioux Falls, who argued that healthcare access should be a priority and highlighted the positive impact that Medicaid expansion has had on thousands of South Dakotans. The proposed amendment follows the state’s 2022 voter-approved Medicaid expansion, which extended coverage to adults with incomes up to 138 percent of the federal poverty level.
The resolution will now be put to a vote in the November 2026 general election, allowing South Dakota voters to decide the fate of Medicaid expansion in the state.
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