South Dakota will have statewide vote on Medicaid work requirement authority

Constitution right now bars Legislature from adopting work requirements

PIERRE — South Dakota voters this fall will decide whether their state Legislature can consider requiring able-bodied adults to work in order to qualify for federal health insurance.

That’s the result of the South Dakota House Republican caucus giving its unanimous approval of a measure brought by Rep. Tony Venhuizen that will place the question on the ballot in November. If approved, the constitutional amendment would give the Legislature the latitude to adopt a Medicaid work requirement, which right now is prohibited under a Medicaid expansion measure voters adopted in 2022.

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Right now, the Biden administration doesn’t allow states to enforce work requirements on Medicaid recipients, though Republican administrations and former President Bill Clinton did. Venhuizen, a former chief of staff in both the Noem and Daugaard administrations, argued that the state should have the flexibility to consider the change should a new presidential administration allow it.

“We know that the time will come again when the federal government allows these to be considered,” Venhuizen said while urging support for his measure Tuesday on the House floor. “We should not be in a position in South Dakota when that happens where we are the only state that can’t consider a work requirement.”