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  • Writer's pictureRick Weiland

SD Medicaid Expansion Fiscal Note (2022)

Updated: May 21, 2021

Contact: Dakotans for Health Press

Date: Thursday, September 24, 2020

Email: Info@Dakotans4Health.Com

South Dakota Legislative Research Council Provides "Fiscal Note"


South Dakota

Dakotans for Health, an emerging group of public officials, caregivers, health care advocates, and concerned citizens supporting the expansion of Medicaid released today the recent ‘fiscal note’ provided by the nonpartisan South Dakota Legislative Research Council (LRC), indicating the fiscal impacts and additional coverage, should the people of South Dakota approve a ballot measure to expand Medicaid in 2022.

LRC Fiscal Note

What Dakotans need to know:

According to the LRC, over 40,000 South Dakotans would be eligible for Medicaid insurance, resulting in annual support of at least $300,000,000 in federal dollars at a cost of $20,000,000.
That is a 1200% or 1-15 return on investment (ROI). For every dollar the state spends, the federal government contributes $15. That is a healthy return on the state’s investment for extending healthcare services to people that can’t afford them and it strengthens our states’ healthcare infrastructure and overall economy.
It is estimated that between 2018 and 2021, South Dakota will miss out on over $1.8 billion in federal funds to provide health services and keep rural hospitals open, in addition to the billions already missed out if the state had moved forward when the ACA passed in 2010.

Fundraising and volunteer recruitment are currently underway to collect petition signatures which are due November 1, 2021.

For more information visit:

Attachments (1)

Fiscal Notes re Medicaid Expansion
Download PDF • 121KB

Additional Background

South Dakota is one of twelve states who has yet to expand Medicaid under the ACA
North Dakota expanded Medicaid in 2015. The program has brought hundreds of millions of additional dollars into the state:
Montana expanded Medicaid in 2015 as well. The program brings an additional $600 Million a year to the state:

Visual Learner Summary: South Dakota gets $15 back for every $1 it puts in. A 15:1 Return On Investment.


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