COUNTERPOINT | South Dakotans want welfare programs to promote work

Guest column by Rep. Tony Venhuizen

Amendment F is based on a core South Dakota value: that our social programs should be a hand-up during tough times, but not a way of life.

Amendment F will allow the state legislature to consider work requirements for able-bodied adults who want to enroll in Medicaid expansion. South Dakota voters approved Medicaid expansion in 2022; this extended health coverage to adults aged 18 to 65 who fall below a certain income threshold and are not disabled. These are able-bodied individuals who can work, yet our constitution currently prohibits the state from even considering a work requirement for this group.

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Amendment F doesn’t impose a work requirement – it merely allows the state to consider one. South Dakota should have the same flexibility as other states to explore whether a reasonable, thoughtfully designed work requirement could encourage able-bodied adults to enter the workforce and reduce long-term dependence on government assistance.

At the core of Amendment F is a fundamental belief in the dignity of work. South Dakotans value personal responsibility and know that work is more than a source of income—it is a way to contribute to society, gain independence, and build a better future. Medicaid expansion, like all social programs, should provide a path to self-sufficiency, not permanent reliance on government support.

Encouraging able-bodied adults to seek work aligns with these South Dakota values. Amendment F empowers individuals by incentivizing them to participate in the workforce and contribute to our state’s economy. And while promoting work, Amendment F also leaves room to provide for exceptions those who cannot work due to illness, disability, family concerns, education, or other valid reasons. South Dakota’s other social programs already include such exceptions, and we can extend that same thoughtful approach to Medicaid.

It’s no coincidence that the organizations opposing Amendment F rely heavily on Medicaid funding or advocate for government-run healthcare. It’s ironic that those who favor the expansion of government-run healthcare are concerned about bureaucracy – after all, government-run healthcare is inherently bureaucratic and inefficient. Medicaid also shifts the cost of healthcare – the more people who remain dependent on Medicaid, the more burdensome and costly the system becomes for everyone else.

Amendment F respects the will of the voters by offering them the chance to refine their decision on Medicaid expansion. In 2022, South Dakotans voted for Medicaid expansion, and the state has implemented that decision. However, voters were not able to vote for Medicaid expansion with a work requirement – there was no middle box or write-in option. Amendment F gives voters the opportunity to weigh in on this specific issue.

Passing Amendment F is not about undermining Medicaid expansion – it’s about ensuring that it serves its intended purpose. By giving voters a choice, we can ensure that Medicaid expansion remains a temporary support system that helps people through tough times while encouraging them to move forward in life.

Currently, the federal government, under the Biden administration, does not allow states to impose a work requirement for Medicaid expansion. However, this will not always be the case. Under the Trump administration, 13 states were approved to implement work requirements. Even during the Clinton administration, there was openness to the idea of work requirements in social programs.

It's likely that a future administration will once again allow states to impose work requirements on Medicaid recipients. When that time comes, South Dakota should be in the same position as the other 49 states. Amendment F ensures that we are ready for that future, giving us the flexibility to make decisions that reflect the values of our state.

South Dakota is well-situated to implement a work requirement in Medicaid expansion. Our state pioneered work requirements in the 1980s, and we are routinely recognized for efficiency in administration of the Medicaid program, and the same department that administers Medicaid already administers work requirements in other social programs today.

At its core, Amendment F asks a simple but important question: Should Medicaid expansion be a temporary support for able-bodied adults, or should it be a long-term solution for those who can work but choose not to? In South Dakota, the answer is clear: it should be a temporary support – a pathway to something better.

By voting yes on Amendment F, you’re supporting the values of work and personal responsibility. Let’s give our state the flexibility to consider solutions that will help able-bodied adults move forward and preserve Medicaid for those who truly need it. Vote yes on Amendment F this November. 

Tony Venhuizen is a member of the South Dakota Legislature, representing District 13 in the state House of Representatives, and a former chief of staff to Govs. Kristi Noem and Dennis Daugaard.