South Dakota Voters Reject Medicaid Expansion Repeal and Higher Amendment Threshold
South Dakota voters rejected Amendment I, a ballot measure that could have repealed the state's Medicaid expansion mandate if federal funding decreased. Supporters of the expansion hope lawmakers will now accept the voters' decision, while some legislators express ongoing concerns…
Sioux Falls, SD, November 8, 2026 —
South Dakota voters have cast their ballots, rejecting two key ballot measures: Amendment I, which proposed repealing the state’s Medicaid expansion mandate under certain conditions, and Amendment L, which sought to raise the threshold for approving constitutional amendments.
Amendment I was designed to repeal the state’s requirement to expand Medicaid if federal funding for the program were to decrease. Supporters of Medicaid expansion expressed a hope that the voters’ decision would lead state lawmakers to accept the outcome and move forward. However, some legislators continue to voice concerns regarding the potential long-term financial implications of the Medicaid expansion program on the state’s budget.
The precise details of the federal funding conditions that would have triggered the repeal under Amendment I were part of the measure’s proposed text. The outcome of the vote means the existing Medicaid expansion mandate remains in place, subject to current federal guidelines and state legislative actions.
In addition to Amendment I, voters also turned down Amendment L. This measure would have increased the percentage of votes required to approve future constitutional amendments, making it more difficult to amend the state’s constitution.
Following the election results, the focus is expected to shift back to legislative discussions surrounding healthcare access and state fiscal planning. The concerns raised by legislators about the budget impact of Medicaid expansion will likely remain a subject of debate in upcoming sessions. The rejection of Amendment L indicates a preference among voters to maintain the current process for constitutional amendments.
Story summarized from the original created by Meghan O’Brien on southdakotasearchlight.com, see more information here.
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