A proposal to repeal South Dakota’s voter‑approved Medicaid expansion is moving forward in the state Legislature. House Joint Resolution 5002 (HJR 5002) would place a constitutional amendment on the November ballot asking voters whether the state should eliminate its requirement to provide expanded Medicaid coverage.
The resolution was introduced on January 21, 2026, by Rep. Aaron Aylward and a group of Republican co‑sponsors. It would repeal Article XXI, Section 10 of the South Dakota Constitution—the provision voters passed in 2022 requiring Medicaid benefits for adults ages 18 to 65 earning up to 138% of the federal poverty level.
The measure has cleared its first major hurdle after a legislative committee yesterday voted 8–4 to send it to the House floor.
Democratic Rep. Erin Healy from Sioux Falls says the expansion is the right thing to do to help less fortunate South Dakotans.
Opponents—including representatives from Sanford, Avera, Monument Health, and AARP South Dakota—said Medicaid expansion has provided stability for tens of thousands of residents and rural hospitals.
If approved by the Legislature, HJR 5002 would bypass the governor and go directly to voters on the 2026 general‑election ballot.
The debate on the resolution heads to the full House, with both supporters and opponents preparing for what could become one of the most high‑profile ballot questions of the election year.
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