People-Powered Ballot Measures Help Fulfill the ACA’s Promise

South Dakota is Seventh State Where Fairness Project has Helped Advance a Medicaid Expansion Ballot Measure

WASHINGTON, DC — Voters in six states have approved citizen-led ballot measures to expand Medicaid, to provide health care coverage to more low-income adults under a key provision of the Affordable Care Act. These states are among the 39 states that have adopted Medicaid expansion, 12 years after President Obama signed the ACA into law. 

As federal efforts to close the Medicaid coverage gap stall in Congress, the citizen-led ballot measure has proven to be the most effective democratic tool to expand Medicaid, including in purple and red states. This year, South Dakotans have joined together to place a Medicaid expansion measure on the November ballot. The ballot measure would expand care to cover 42,500 South Dakotans.

South Dakota is among the 12 states where state executives and legislatures have failed to expand Medicaid — even after the federal government offered fresh incentives through the American Rescue Plan to ensure people had access to health coverage during the pandemic.

Statement from Kelly Hall, Executive Director of Fairness Project:

“Ballot measures have given people across the country the key to unlocking the promise of Medicaid expansion made available through the Affordable Care Act. Time and again, we have seen voters choose health care for their neighbors — extending much-needed health coverage to over 830,000 Americans to date. More than a decade later, the benefits of the ACA are helping improve outcomes and creating healthier communities. We’re proud to stand with South Dakotans as they advance their Medicaid expansion ballot measure to help hardworking families gain access to health coverage.”  

Fairness Project has supported all of the successful state-based ballot measures to expand Medicaid since 2017: Idaho, Maine, Nebraska, Oklahoma, Missouri, and Utah. These six Medicaid expansion victories are included in the organization’s record of winning 23 of 24 ballot measure campaigns to support working families. 

Medicaid expansion helps parents, farmers, near-retirees, small business employees, and workers with jobs that don’t offer health care or who simply can’t afford it. They earn too much currently to qualify for Medicaid, but not enough to afford care on their own. Medicaid expansion also helps keep rural hospitals open for when an emergency strikes and ensure that all families have access to emergency care — regardless of where they live.