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Republican lawmakers want to reintroduce Medicaid work requirement question

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Two Republican lawmakers want to ask state voters to add work requirements for Medicaid recipients.

That’s despite the idea failing last session and voters recently approving expanding coverage for working adults.

Medicaid expansion was approved by 56 percent of voters in 2022. The provision, now in the state constitution, says the state may not impose burdens or restrictions on eligibility or enrollment.

Republican Rep. Tony Venhuizen and others say that aspect was not central to the Medicaid expansion question. They want to ask voters to clarify.

“It’s important to understand this is a process that submits the question back to the voters,” Venhuizen said. “It’s like a clarification. ‘Alright, we have Medicaid expansion, that’s what you wanted. Do you think we should be allowed to consider a work requirement or not?’ What could be honoring the will of the voters more than asking the will of the voters?”

Venhuizen likens the Medicaid work requirement to the state's work requirement for food stamps.

He said with the state’s workforce shortage, the issue is even more crucial. The state’s unemployment rate sits at two percent.

The potential question will look like the one proposed last legislative session. The requirement will only apply to someone who is physically and mentally able to work.

Critics say the move it will burden businesses and working individuals.

Ben Hanson, the government relations director for the American Cancer Society Action Network in South Dakota, worries about Medicaid-eligible workers undergoing treatment for a cancer diagnosis—whether chemo or radiation.

“There are no carveouts or specifications for those undergoing treatments for terminal diseases. We don’t know what these work requirements look like," Hanson said. "There’s just no point in putting unnecessary undue burden, adding to something that South Dakota voters clearly wanted.”

More than 10,000 adults are enrolled under Medicaid expansion. That’s around 20 percent of what lawmakers expected.

Lee Strubinger is SDPB’s Rapid City-based politics and public policy reporter. Lee is a two-time national Edward R. Murrow Award winning reporter. He holds a master’s in public affairs reporting from the University of Illinois-Springfield.