FEBRUARY 29, 2024:
UNDATED (AP)- South Dakota voters will decide this fall whether the state can impose work requirements on certain low-income people receiving Medicaid health care coverage, which would modify the program expansion voters approved in 2022.
The Republican-controlled Legislature has put the measure on the November ballot, with the state House approving the resolution in a 63-7 vote on Tuesday (Feb. 27, 2024). The Senate previously adopted it, 28-4.
South Dakota Republican lawmakers want to add a work requirement for adults who are not physically or mentally disabled but who are eligible for Medicaid under the expansion of the government-sponsored program that voters approved in 2022 under a ballot initiative. The change, which took effect last summer, greatly increased the number of people in the state who qualify for Medicaid.
Even if voters approve the measure, the federal government will have to sign off on a work requirement.
The expansion was previously opposed by both Republican Gov. Kristi Noem and the GOP-controlled Legislature, which defeated a proposed Medicaid expansion earlier in 2022.
The 2022 constitutional amendment expanded Medicaid eligibility to people who earn up to 138% of the federal poverty level, which the state Department of Social Services says is up to $41,400 for a family of four.
Republican Rep. Tony Venhuizen, a prime sponsor of the work requirement measure, described it as a “clarifying question” for voters on a specific point.
“When you listen to the opposition on this, you hear people who very clearly want people to go on Medicaid expansion and stay on it for a long period of time as their plan for health care, and I just don’t think that’s the purpose of social programs in South Dakota. We want to give people a hand up to a better life,” Venhuizen said.
Details of and exemptions from the work requirement are “like step 10,” he told a House panel Monday during a hearing for the resolution. “What we’re talking about today is step one.”
Supporters also have pointed out that other assistance programs, such as food benefits, have work requirements.
Opponents have said a work requirement would be unnecessary, ineffective and against the will of voters in 2022. South Dakota has a 2% unemployment rate, behind only Maryland and North Dakota, according to the U.S. Bureau of Labor Statistics in January.
“Who is not working? Who is on Medicaid and is not working? And I can answer that for you, it’s the poorest of the poor,” said Democratic Rep. Kadyn Wittman, who called the measure’s consideration “deeply offensive to every individual that voted yes” for Medicaid expansion in 2022.
The expanded eligibility took effect July 1, 2023. Nearly 20,000 people have since enrolled. More people are expected to enroll. The department estimated 52,000 new people would qualify for Medicaid expansion when it opened.
JANUARY 26, 2024:
Supporters want to give South Dakota voters the chance to “clarify” whether or not the state should have the option of adding a work requirement for able bodied individuals who receive Medicaid….while opponents say such requirements are not effective and they would constitute an expansion of government control.
The state Senate State passed SJR 501 on a 28-4 vote Thursday (Jan. 25, 2024).
Resolution sponsor, Republican Rep. Tony Venhuizen of Sioux Falls, said he doesn’t think voters understood that the constitutional amendment they passed in 2022 to expand Medicaid did not have a work requirement for non-disabled people. He, and other proponents, argued that the proposed change would not mandate a work requirement, but would provide the option to add it– if the federal government and the state legislature approved it in the future.
Senate Minority Leader Senator Reynold Nesiba from Sioux Falls is adamantly against the work requirement option.
House Minority Leader Representative Oren Lesmeister from Parade is also opposed to the possibility of adding a work requirement for able-bodied Medicaid recipients.
The resolution now goes to the House for further consideration.
JANUARY 25, 2024:
By Todd Epp, South Dakota Broadcasters Association
PIERRE, S.D. (SDBA) — South Dakota voters would get a chance to “clarify” if they meant for low-income people to have to work to receive Medicaid benefits passed in the 2022 general election.The Senate State Affairs Committee passed SJR501 on a 7 to 1 vote Wednesday (Jan. 24, 2024).
Resolution sponsor, Republican Rep. Tony Venhuizen of Sioux Falls, said he did not think it was clear if voters understood that the state constitutional amendment they passed expanding Medicaid did not have a work requirement for non-disabled people.
“I do not believe this was the central issue that the voters were considering,” Venhuizen testified. “It certainly wasn’t discussed in the advertising. When you have a ballot measure, the question is yes or no.”
Opponents of the resolution took issue with Venhuizen’s assertion.
“We believe this argument is unfair to voters that cast their ballots in 2022,” said Eric Nelson, lobbyist for AARP. “AARP South Dakota held multiple events for the 50-plus population across South Dakota throughout 2022 to educate voters on amendment D. Part of our presentation explained that Medicaid expansion enrollees would have the same benefits and parameters as the traditional Medicaid population.”
Venhuizen and other proponents argued that the changes to the state constitution on Medicaid would not mandate a work requirement but would allow it if the federal government and the state legislature approved it in the future.
“But what we are proposing is to give South Dakota the flexibility to respond if and when that option becomes available,” Venhuizen said. “This is step one. This does not create a work requirement.”
Opponents said, nevertheless, that studies show that work requirements don’t work because they are bureaucratic and can delay people getting coverage. Further, according to the studies, more people do not end up working.
At one point in the hearing, Democratic Sen. Reynold Nesiba from Sioux Falls angrily asked Venhuizen, “How many more staff are you going to have to hire at DSS (Department of Social Services) so we can kick people off of healthcare?”
Venhuizen deferred to DSS Secretary Matt Althoff.
“I think experience is going to help drive us,” he said.
Althoff said he couldn’t know how many more full-time employees the department would need if a work requirement were implemented. The department hired 60 new employees to handle the expansion. Althoff said about 18,000 South Dakotans have applied for the expanded Medicaid program. The department had predicted 57,000, but applications have been coming in slower than expected.
SJR501 now moves to the Senate floor. The state constitutional amendment would go on the 2024 ballot if passed by the legislature.
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