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Home ACA Compliance South Dakota Medicaid Expansion on The Ballot This Fall

South Dakota Medicaid Expansion on The Ballot This Fall

3 minute read
by Robert Sheen

The ACA may broaden again this fall as voters decide whether South Dakota should join 38 other states in expanding Medicaid.

Despite Republican pushback from legislators, South Dakota would follow a trend that started a few years ago in expanding Medicaid. Since the ACA was passed 12 years ago, six other red states have voted yes on Medicaid expansion through citizen-started measures.

Now, this doesn’t mean it’s smooth sailing for the ACA initiative in South Dakota just yet. Earlier this year, GOP leaders attempted to institute a measure that would force future initiatives to meet a 60% supermajority to pass. The intent was to make it more challenging for Medicaid measures to be voted in. Fortunately, South Dakota residents recognized the attempt and did not vote it in. 

Before the Supreme Court’s decision in 2012 made Medicaid expansion optional for states, the only people who had a real say in healthcare options for Americans were legislators and state governors. The current Governor of South Dakota, Kristi Noem, is opposed to the expansion, but she won’t have the last word. 

State voters will ultimately determine the fate of Medicaid expansion this fall. If passed, it would take effect beginning July 1, 2023.

What is Medicaid Expansion?

Medicaid expansion was first introduced in 2010 as part of the span itemprop=”product”>ACA. It essentially allows Americans’ income level to decide whether they qualify for government-subsidized healthcare, not the presence or lack of a disability. 

Some 3.7 million Americans across the country would become eligible for Medicaid if the remaining 12 states adopted the ACA measure. In South Dakota, anyone under 65 earning under $18,700 annually would become eligible.

Medicaid expansion benefits many

As previously seen in other states like Missouri and Oklahoma, the move to widen Medicaid in South Dakota would be beneficial for the state’s citizens and financial budget. Overall, South Dakota would see 45,000 more people with health insurance and potentially save upwards of $384 million. Of the new residents to potentially gain coverage, over a third are Native Americans.

Other states may be facing a similar situation in the not-too-distant future. Of the remaining 12 states that haven’t passed Medicaid expansion, three other states allow citizens to initiate measures on the ballot: Florida, Mississippi, and Wyoming. As the success of Medicaid expansion measures continues, voters in those states are much more likely to want the same opportunities.

The remaining eight states that have refused Medicaid expansion, including Texas, don’t allow citizens to collect signatures and put measures on the ballot. 

The work to pass any expansion plans is fighting an uphill battle. Opponents in all states argue that passing the Medicaid expansion to the ACA would force state taxes to rise, although the federal government covers 90% of the expansion’s cost.

ACA further rooted in U.S. healthcare

We won’t know until November if Medicaid expansion is happening in South Dakota, but one thing is for certain: the ACA is here to stay. Twelve years after the ACA was first passed, it’s becoming further ingrained into U.S. healthcare. While states like South Dakota are slower to adapt, the sentiment is that ACA initiatives like Medicaid expansion are paramount to the overall integrity of healthcare in the U.S.

Meanwhile, Republicans recently abandoned their repeal and replace campaign, further signaling to employers that the ACA is here to stay. Employers that were anticipating the law to be eliminated must act quickly to ensure they’re complying with the ACA responsibilities under the Employer Mandate.

Under the Employer Mandate, organizations with 50 or more full-time and full-time equivalent workers must provide Minimum Essential Coverage  to at least 95% of their full-time workforce or face the consequences of Internal Revenue Code Section 4980H.

If your organization needs assistance meeting the requirements of the ACA’s Employer mandate, contact us to learn about our full-service solution, ACA Complete. We’ve helped thousands of organizations prevent over $1 billion in ACA penalty assessments.

For assistance coding your ACA information ahead of the upcoming 2022 ACA reporting deadlines, download the Employer’s Guide to Coding ACA Form 1095-C below:

Download Employer's 1095-C Guide

For information on ACA penalty amounts, affordability percentages, important filing deadlines, steps for responding to penalty notices, and best practices for minimizing IRS penalty risk, download the ACA 101 Toolkit.

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