South Dakota Senate passes resolution on Medicaid work requirements


The Republican-led South Dakota Senate passed Senate Joint Resolution (SJR) 501 on January 25, 2024, which would ask voters to weigh in on a proposed constitutional amendment allowing for work requirements in the state’s expanded Medicaid program.

South Dakota voters in November 2022 approved a constitutional amendment to expand Medicaid to people who earn up to 138% of the federal poverty level. SJR 501 seeks to put a separate constitutional amendment to voters in November 2024 allowing the state to require adults under the age of 65 without mental or physical disabilities to work to remain eligible for Medicaid.

The resolution next heads to the Republican-led House of Representatives, needing a simple majority to pass. If passed, the proposed amendment would head to voters in the November 2024 election, again requiring a simple majority. Finally, the Centers for Medicare and Medicaid Services would need to approve the program. 

“Really, it’s a fundamental question,” the new Senate Majority Leader Casey Crabtree (R) explained. “Do we want to incentivize those who can, or are able-bodied, those who can work, to do so? Or do we want to leave a gap where government dependency can become a way of life?”

“This is about government bureaucracy,” Senate Minority Leader Reynold Nesiba (D) asserted. “This is about denying health care to people who otherwise qualify for it.”

Additional reading:

  1. South Dakota Constitutional Amendment D, Medicaid Expansion Initiative (2022)
  2. Medicaid work requirements