South Dakota Republicans respond to Medicaid expansion with work requirement bill that defies federal law

South Dakota Republican lawmakers on Monday advanced a proposed constitutional amendment that would allow the state to try and force people on Medicaid to work despite federal policy prohibiting such requirements. .

The proposal would change the state constitution and require voter approval in 2024. All 11 Republicans on the House State Affairs Committee voted Monday to advance the legislation to the full House. The two Democrats on the panel voted against it.

Voters in South Dakota in November approved expanding Medicaid eligibility to people making 138% of the federal poverty level.

Republican Rep. Tony Venhuizen of Sioux Falls, who sponsored legislation to allow the state to require people to work for Medicaid benefits, said it would push them to find jobs. The main proponents of giving Medicaid to more people argued that it would weaken the expansion before it it has even been implemented.

The federal government has banned states from requiring work for Medicaid eligibility, but Venhuizen said that could change. The proposed amendment to the state constitution would let voters decide, he argued.

“I think they see the value of work and of encouraging work for people who can,” Venhuizen said.

But organizations that supported Medicaid expansion last year said such a requirement failed to account for people who could not continue working because of disabilities. It’s also expensive and difficult to police, said Deb Fischer-Clemens, a lobbyist for Avera Health and several other health care groups.

The Trump administration has tried to impose work requirements for public programs, but states that enforce the requirements have been challenged in federal courts.

A federal judge ruled that work requirements have created many barriers for poor people trying to get health care, which federal and state officials have failed to adequately assess or address.

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