Democrats warn HJR 501 could be first step toward curbing Medicaid expansion

Senate Minority Leader Liz Larson urged citizens to contact House members to oppose a joint resolution she said could limit Medicaid coverage for tens of thousands of South Dakotans if federal funding changes.

Larson described HJR 501 as "the next step to strip health insurance from thousands of South Dakotans," saying the measure would give voters the option to eliminate coverage for about 20,000 people if the federal match changed. "This is a trajectory to get rid of Medicaid or at least lessen it," she said.

Other legislators and Republican speakers said HJR 501 would put the decision back to voters if the federal funding formula changes and argued that voters who approved expansion should be able to reassess it in light of a changed federal share. A Republican press-conference speaker said: "When we leave things up to people, the right things normally get done. Not always, but normally, the right things are getting done."

Why it matters: Medicaid expansion covers many low-income residents; altering funding mechanisms or giving voters a choice if the federal match declines could result in coverage losses for people currently enrolled. Both sides said the ballot approach would let voters decide important fiscal trade-offs.

Clarifications Larson emphasized that federal funds supplied a large share of expansion costs and warned that ballot-driven changes could be the first of several steps to reduce coverage. Other speakers said the ballot route simply returns the matter to voters if federal funding conditions change.

Ending Lawmakers said the outcome would ultimately depend on the ballot process and on future federal decisions about Medicaid's matching rates.