A long road for Medicaid work requirements in South Dakota
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South Dakotans passed Amendment F on Election Day, opening the door to impose work requirements on people who qualify for expanded Medicaid benefits.
Opponents said it could interrupt health treatment for those fighting cancer and other diseases. Any bill outlining work requirements for Medicaid would still need state passage and federal approval.
A report from the Congressional Budget Office on the effects of a similar rule finds it would reduce federal spending, decrease the number of people with health insurance and would not increase employment.
Ben Hanson, South Dakota government relations director for the American Cancer Society Cancer Action Network, said it would also cost the state.
"For the most part, state health departments will tell you, you're not going to save money by doing this," Hanson asserted. "You're going to wind up spending more to create a bureaucracy to oversee this new set of forms and paperwork they have to fill out, for an already qualifying population."
President-elect Donald Trump approved work requirements in 13 states during his last term, all of which were rescinded or withdrawn under President Joe Biden. South Dakota is one of nine states with pending programs or legislation to allow them.
Most adults with Medicaid benefits who are able to work are doing so. According to the health research organization KFF, of those under age 65 who do not have other state-sponsored care, 91 percent are either working, or not working because they are students, caregivers or are ill themselves. Hanson said, for instance, many people who go through cancer treatment miss work for several months because of its physical toll.
"This could take away your coverage for getting that treatment while you're trying to get better so you can go be an employee again," Hanson noted. "And more importantly, so you can survive your cancer diagnosis."
Hanson added work requirements might also prevent early cancer detection, which leads to more expensive treatment and worse outcomes.