The South Dakota Department of Social Services says roughly 1,213 people on expanded Medicaid — about 4% of enrollees — could lose coverage once new federal work requirements take effect in 2027. The rules, passed by Congress last year, will require adults ages 19 to 64 to work, volunteer, or attend school 80 hours a month. Renewals will also shift from once a year to every six months.
The department says most of the nearly 29,500 expanded Medicaid recipients already meet exemptions or work requirements through other federal programs. But about 6,000 people couldn’t yet be verified, and officials estimate around 20% of that group may not qualify by the time the rules begin.
Exceptions will apply for people who are disabled, pregnant, eligible for Indian Health Service, in foster care, recently released from incarceration, and other federally defined categories.
Officials say they’re working with tribal representatives, medical providers, and advisory groups to make sure recipients understand the upcoming changes. Disenrollments would occur gradually throughout 2027 as people come up for renewal.
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