Medicaid expansion in South Dakota could come slowly
Photo: Brent Nathaniel

November 14, 2022

PIERRE, S.D.–South Dakotans voted last week to expand the state’s Medicaid program to cover thousands of additional low-income residents, becoming the seventh state to approve expansion via the ballot box.

But as other conservative states have shown, voter approval doesn’t always mean politicians and administrators will rush to implement the change.

In Missouri, for example, experts said subpar publicity efforts and an outdated application system led to a glacial pace of enrollment after voters there approved Medicaid expansion in 2020.

A similarly slow rollout could occur in South Dakota according to Tricia Brooks, a Georgetown University research professor who studies Medicaid.

Brooks says South Dakota’s Medicaid computer system “has a long way to evolve. Unless they’re going to really boost their eligibility [processing] capacity, then I think we’re in for a rough or rocky start to expansion.”

That could leave some South Dakotans temporarily uninsured even after they become eligible for Medicaid coverage.