- Associated Press - Thursday, May 6, 2021

SIOUX FALLS, S.D. (AP) - The South Dakota Supreme Court has rejected an effort by Medicaid supporters to challenge a constitutional amendment that would make it more difficult to expand the federal program to more people in need.

The ruling Wednesday is the latest setback for the Medicaid expansion group, Dakotans for Health, in a series of back-and-forth tussles with the Legislature. The group wants South Dakota voters to pass a constitutional amendment in November 2022 to make Medicaid health insurance available to people who live below 133% of the federal poverty level.

But the Legislature this year proposed its own constitutional amendment that would require ballot initiatives such as the proposed Medicaid expansion to meet a 60% vote requirement if they introduce or adjust taxes, or spend more than $10 million in any of the five years after enactment.



Constitutional amendments must be approved by a majority of voters and ordinarily would appear in the November general election. But lawmakers, with an eye on the Medicaid expansion vote, pushed their constitutional amendment proposal onto next June’s primary election ballot, when fewer voters are expected to take part.

Democrats and some Republicans have criticized the resolution as an “unfair” move to head off ballot initiative campaigns already in progress. Nonetheless, the resolution passed.

Dakotans for Health filed a petition in March with the Secretary of State to challenge the Legislature’s action through a popular vote in the November 2022 election - a move that would have postponed the vote on the proposed constitutional amendment and ensured Medicaid expansion needed a simple majority to pass. But the Secretary of State rejected the petition, reasoning that the Legislature’s proposal - known as House Joint Resolution 5003 - cannot be challenged at the ballot as if it was a law.

The Supreme Court on Wednesday unanimously ruled in support of that decision.

“HJR 5003 is not a law enacted by the Legislature, and as a result, there is nothing in HJR 5003 to refer to the electors at the November 2022 general election,” wrote Chief Justice Steven Jensen.

The ruling means voters will consider the Legislature’s constitutional amendment in the June 2022 primary election. If it is approved, the Medicaid expansion ballot initiative will face a 60% vote threshold to pass later that year.

Rick Weiland, the co-founder of Dakotans for Health, said the Legislature’s resolution was a political maneuver that sets a poor precedent, but given the legal defeat, the group will focus its efforts on mounting an opposition campaign in the June 2022 primary election.

“We’re not going to disarm and call it good,” he said. “We’re just going to double down and move forward.”

Weiland said the Medicaid expansion proposal would help up to 42,500 people who often scrape by, struggling to pay for health care. It would also make the state eligible to receive more federal funds for Medicaid. But conservative lawmakers have argued that voters who want to pass laws that spend government funds should face a similar hurdle for approval to what the Legislature faces. They are required to get a two-thirds majority for bills that spend funds or raise taxes.

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