Medicaid in South Dakota Since Expansion.

Abstract

In 2023, South Dakota expanded the Medicaid program, providing health coverage to an additional 29,500 residents who were previously ineligible. Prior to expansion, Medicaid eligibility was limited leaving many South Dakotans without affordable health insurance. This gap in care contributed to significant disparities in healthcare access and outcomes across the state. Medicaid expansion was initially proposed under Senate Bill 186 and later passed during state elections under Amendment D in 2022. The rollout of the expansion program has faced challenges since its initiation with lower enrollment than expected, potentially due to less marketing and an outdated application system. Further the COVID "churning" effect, where thousands of individuals were disenrolled due the cessation of COVID-19 emergency protections, occurred in the spring before the Medicaid expansion start date of July 1, 2023, leading to confusion for many enrollees. Despite these challenges, Medicaid expansion has already provided crucial healthcare access to vulnerable populations, including Native American, Black, Hispanic, and Asian communities. However, the recent passing of work requirements under Amendment F, could impact the future of the program. As South Dakota continues to navigate the complexities of Medicaid expansion, ongoing evaluation will be crucial in ensuring the state maximizes the potential of the program.