South Dakota Constitutional Amendment I: Ends Medicaid expansion if federal funding drops below 90%
On the November 3, 2026 ballot. Ask the guide what a yes vote and a no vote would each do, in the official wording.
The question on the ballot
Constitutional Amendment I. Title: An Amendment to the South Dakota Constitution that Repeals Expanded Medicaid Coverage if Federal Funding for the Program Drops below 90%. Attorney General Explanation: Medicaid is a program, funded by the State and the federal government, to provide medical coverage for low-income children, pregnant women, disabled individuals, and the elderly. In the 2022 General Election the voters approved Constitutional Amendment D, which expanded Medicaid eligibility in South Dakota. Amendment D requires the State to also provide Medicaid benefits to anyone over the age of 18 and under 65 whose income is at or below 133% of the federal property level, plus 5% of the federal poverty level for the applicable family size. Currently, federal law requires the federal government to fund 90% of South Dakota’s Medicaid expansion. This proposed Constitutional Amendment ends the expanded Medicaid coverage if the federal funding for expansion drops below 90%. If federal funding drops below that 90% threshold, Medicaid coverage will once again only apply to low-income children, pregnant women, disabled individuals, and the elderly. Vote “Yes” to adopt the amendment. Vote “No” to leave the Constitution as it is.
Where, when and how to vote
The guide doesn't answer these. The current, official answers are with South Dakota Secretary of State.