Constitutional Amendment I — An Amendment to the South Dakota Constitution that Repeals Expanded Medicaid Coverage if Federal Funding for the Program Drops below 90%.

What it does

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.

A YES vote means

A yes vote ends the constitutional requirement for expanded Medicaid coverage if the federal share of its funding drops below 90%.

A NO vote means

A no vote keeps expanded Medicaid coverage in the Constitution regardless of the federal funding level.

Needed to pass

A simple majority

Put on the ballot by

the Legislature

Official text: source

Also on South Dakota ballots

• Constitutional Amendment J — An Amendment to the South Dakota Constitution Clarifying that an Individual Must Be a Citizen of the United States to be Eligible to Vote.
• Constitutional Amendment K — An Amendment to the South Dakota Constitution Establishing the Trust for Unclaimed Property Fund.
• Constitutional Amendment L — An Amendment to the South Dakota Constitution Requiring that a Proposed Constitutional Amendment or Revision Receive an Affirmative Vote of Sixty Percent of the Votes Cast.

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Quick answers

What does a YES vote on South Dakota Constitutional Amendment I mean?

A yes vote ends the constitutional requirement for expanded Medicaid coverage if the federal share of its funding drops below 90%.

What does a NO vote on South Dakota Constitutional Amendment I mean?

A no vote keeps expanded Medicaid coverage in the Constitution regardless of the federal funding level.

How many votes does South Dakota Constitutional Amendment I need to pass?

A simple majority

Should I vote yes or no on South Dakota Constitutional Amendment I?

SpectrumVote doesn't endorse anyone or tell you how to vote. Read what a YES and a NO vote each do, and the official text, then decide based on what you want to happen.

When is the vote?

The general election is Tuesday, November 3, 2026. Early voting and mail-ballot deadlines vary by state; check your state or county election office.