On October 31, 2026, South Dakota voters will consider a Republican-led ballot measure that could repeal Medicaid expansion if Congress lowers federal matching payments. This proposal reflects a broader trend of 'trigger laws' in several states, which would eliminate Medicaid expansion if federal funding decreases. Experts, including Adam Searing and Natasha Murphy, have raised concerns about the potential negative impact on healthcare providers and rural populations in South Dakota. Despite attempts at the federal level to reduce matching funds, no changes have been made so far.
Key facts
- South Dakota voters will decide on a Medicaid repeal measure on October 31, 2026.
- The measure would repeal Medicaid expansion if federal matching payments drop below 90%.
- Ten states have already implemented similar Medicaid 'trigger laws'.
- Federal matching funds were established to incentivize Medicaid expansion under the Affordable Care Act in 2010.
- Experts warn that funding cuts could severely impact healthcare in rural areas.
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