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AARP AARP States South Dakota Advocacy

SD Legislature Week 3: The Ups and Downs of the Legislative Process


We just completed week three of the legislative session and are already seeing the ups and downs this process brings each year.

On Wednesday during a Senate State Affairs committee hearing, AARP South Dakota testified in opposition of Senate Joint Resolution 501 (SJR) 501, which proposes to the voters during the November 2024 general election an amendment to the Constitution of the State of South Dakota authorizing the state to impose work requirements on certain individuals who are eligible for Medicaid expansion.

Unfortunately, the committee passed SJR 501 on a 7-1 vote, and the bill passed in the Senate on a 28-4 vote.

AARP South Dakota was part of the South Dakotans Decide healthcare coalition that put Amendment D (Medicaid expansion) on the November 2022 ballot. This coalition was one of the largest groups of statewide organizations to ever come together around a ballot measure, and South Dakota voters overwhelmingly approved the initiative.

By introducing SJR 501, our South Dakota legislature is telling voters, specifically the 50-plus voters who always show up for elections, they didn’t know what they were voting for in 2022. And, they introduced this measure even after a similar bill failed last year only months after Amendment D passed and well before Medicaid expansion was even implemented.

This argument is unfair to the voters that cast their ballots in 2022 and ignores the expertise and efforts of the coalition of South Dakota organizations that supported Amendment D – and that continue to support the implementation of Medicaid expansion as directed by South Dakota voters.

AARP South Dakota held multiple events for the 50-plus population across South Dakota throughout 2022 to educate voters on Amendment D. Part of our presentation explained that the Medicaid expansion enrollees would have the same benefits and parameters as the traditional Medicaid population. At each presentation, we were asked about work requirements, and we explained that if work requirements were implemented on the traditional Medicaid program, they would apply to the expansion population. We also noted that a work requirement waiver had been submitted by the state to the federal government in 2018 and hadn’t been acted on - which remains the case.

Throughout 2022, the opponents of Medicaid expansion did not campaign against Amendment D by highlighting any concerns relating to work requirements. Instead, our legislature put Amendment C on the June 2022 primary ballot in an attempt to circumvent Medicaid expansion before the vote in November. South Dakota voters, including voters 50-plus, saw through this tactic and overwhelmingly rejected Amendment C.

SJR 501 isn’t as simple as it sounds, and voters will ask questions regarding the resolution that can’t be answered. For example, what if an AARP SD member asks their legislator in March how many people in the Medicaid expansion program will be impacted by a work requirement? That answer is unknown.

Implementation of the program has only been in place for a little over 6 months and enrollment numbers will continue to grow and fluctuate. Also, as of last November, the Department of Social Services (DSS) informed the South Dakota Medicaid Advisory Committee that DSS does not have an accurate way to track the employment status of the Medicaid expansion population.

Finally if an AARP SD member asks for a definition of “able bodied individuals” and if there will be an exemption for a family caregiver related to SJR 501, the answer is, “we don’t know and we won’t know before the November election.”

A bigger problem South Dakotans age 50-64 continue to face is not having affordable, accessible healthcare through their employer, which puts them in the Medicaid expansion population. With South Dakota’s unemployment rate under 2%, if our legislature is truly concerned about the Medicaid expansion population, addressing this issue should be a top priority.

On the “UP” side, however, with AARP South Dakota’s support, House Bill 1013 (HB 1013) has passed and now awaits the Governor’s signature. This measure adopts the Advanced Practice Registered Nurse (APRN) Compact. On Monday, AARP South Dakota testified in favor of the bill, and the Senate Health and Human Services unanimously voted for it on a 7-0 vote. On Tuesday, the bill passed on a 30-3 vote on the Senate floor.

South Dakota faces pressing healthcare challenges—an aging and diverse population, more people with chronic conditions, increasing numbers of people who are uninsured, rising costs and a shortage of providers. We can help address some of these challenges by maximizing the use of APRNs to tackle healthcare challenges in access, quality and cost which is why AARP South Dakota supported HB 1013.

The passage of HB 1013 is a win for our nurses and patients across the state!

Lobby Day is Next Week
On Tuesday, January 30, legislators will be seeing red as more than 70 advocates wearing red AARP South Dakota vests visit the Capitol. Watch for updates on our social media throughout the day on Tuesday as we have the opportunity to chat one-on-one with lawmakers and represent South Dakotans 50-plus and their families.

Connect with Lawmakers at Legislative Cracker Barrels
Another great way for you to make your voice heard, along with sending emails or making phone calls, is to attend local legislative coffees or "cracker barrel" sessions held on the weekends when legislators are back in their home districts. We have compiled information on some locations that have already announced upcoming cracker barrel sessions. Is your community hosting a cracker barrel event? Email us the information at and we will update our list.

Please reach out if you have any questions or feedback during this legislative session:
Phone: 605-350-6348

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