Health-related nonprofits are funding opposition to the Medicaid work requirement ballot question

Joshua Haiar, South Dakota Searchlight

Most of the campaign spending on a ballot question regarding work requirements for Medicaid expansion recipients has been on the “no” side, with major donations from nonprofits that advocate for people with serious medical conditions.

Amendment F would change the South Dakota Constitution to allow legislative consideration of work requirements for people receiving Medicaid under expanded eligibility approved by voters in 2022.

The sole statewide ballot question committee organized in response to the measure is Vote “No” on Amendment F. The committee recently reported raising $470,000 since September and spending $250,000. Contributions included $313,000 from the American Cancer Society, $65,000 from the American Heart Association and $33,000 from the Leukemia & Lymphoma Society.

Additionally, AARP South Dakota reported spending $97,000 directly on Amendment F advertising, without giving the money to a ballot question committee. The group has a page on its website that encourages South Dakotans to vote no on the measure.

There is no ballot question committee organized specifically to support Amendment F. Ads on YouTube urging a yes vote on Amendment F and a no vote on other ballot questions identify a political action committee, Concerned Citizens of South Dakota, as the responsible entity. The committee reported spending about $6,000 on advertising in its most recent report.

In 2022, South Dakota voters expanded Medicaid eligibility to adults with incomes up to 138% of the poverty level. The expansion is now part of the state constitution and can only be altered by voters. It includes a ban on “greater or additional burdens or restrictions” such as a work requirement.

Earlier this year, legislators decided to put Amendment F on the Nov. 5 ballot. It would allow lawmakers to consider a work requirement if the federal government permits it. The Democratic Biden administration does not allow it, but future Republican presidents might.