Resolution would let voters decide Medicaid expansion work requirement

(The Center Square) – The South Dakota House of Representatives will consider a resolution to give voters a say in whether nondisabled Medicaid recipients should work.

Voters agreed to expand Medicaid in 2022 to nondisabled individuals between the ages of 18 and 64. The change allows individuals and families who make up to 138% of the federal poverty level to receive the health care plan.

Senate Joint Resolution 501 does not authorize the expansion but lets voters decide, said Rep. Tony Venhuizen, R-Sioux Falls, one of the prime sponsors.

“We’re honoring the will of the voters because we are going back to the voters and asking what I view as a clarifying question, not to reverse their decision from last time but to clarify on a particular detail,” Venhuizen told the Senate State Affairs Committee this week. “Is this something we should be able to consider?”

The work requirement could only be imposed if the federal government allows it and would only affect people deemed medically fit to work. Exceptions would include parents caring for young children or someone who has cancer and is unable to work, Venhuizen said.

Matt Althoff, secretary of the Department of Social Services, said a work requirement is already in place for other programs.

Several business organizations testified in favor of the bill, citing worker shortages.

“When I talk to small businesses across the state and ask what their challenges are, almost every one of them says workforce,” said Jason Glodt, state director for the National Federation of Independent Businesses. “They have a difficult time finding employees. So anything you can do to help workforce development is certainly welcome.”

Kim Malsam-Rysdon, vice president of public policy of Avera Health and former secretary of health under Gov. Kristi Noem, said her organization understands workforce concerns. It employs 20,000. Work requirements do not work, she said. A study of Arkansas’ work requirement published in “Health Affairs” found no evidence that the policy succeeded, Malsam-Rysdon said.

“Not surprisingly what we did find in Arkansas is that people lost their coverage,” Malsam-Rysdon told the Senate State Affairs Committee. “They were not able to comply with the burdensome administrative requirements that often come with these kinds of things that are tied to government programs. So they went without health care which is exactly why voters voted to extend Medicaid to low-income individuals.”

The Senate approved the resolution 28-4 on Thursday. If approved by the House and signed by Noem, the referendum will appear on the November ballot.

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