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AARP AARP States South Dakota Advocacy

South Dakota Medicaid Expansion on the Ballot


Voters in November will decide whether to expand Medicaid—the government health insurance program for low-income Americans—to include an estimated 42,000 South Dakota adults.

Constitutional Amendment D on the ballot would extend Medicaid coverage to South Dakotans under 65 who earn less than 138 percent of the federal poverty level, or about $18,700 for a single person in 2022. South Dakota is one of 12 states that has not expanded Medicaid under the Affordable Care Act.

Supporters say expansion would boost health care access, bring in millions of dollars in federal funding to the state and help rural hospitals remain open. Opponents have raised concerns about the cost, arguing it could lead to higher state taxes. (The federal government covers 90 percent of the cost of expansion.)

Election Day is Tuesday, Nov. 8. Get voting details at and at