Pierre, S.D. — In a win for patients, providers, farmers, small businesses, and thousands of working families, South Dakotans voted today to expand Medicaid, becoming the 40th state to do so since the passage of the Affordable Care Act in 2009. The South Dakotans Decide Healthcare campaign, backed by the Fairness Project, won its “Yes on Amendment D” effort Tuesday night. At the time of the race call shortly before 1 a.m. ET, the “Yes” votes were leading 55% to 45%.

“We are thrilled by this victory, which took years of work, coalition building, and organizing to achieve. The Fairness Project is incredibly proud to celebrate our seventh successful Medicaid expansion campaign alongside South Dakotans Decide Healthcare and essential partners from around the state,” said Fairness Project Executive Director Kelly Hall. “South Dakotans know their families and neighbors deserve health care without going into debt or avoiding check-ups, procedures, and medication they need. Citizens took matters into their own hands to pass Medicaid expansion via ballot measure — showing us once again that if politicians won’t do their job, their constituents will step up and do it for them.” 

Beginning next year, families and individuals in South Dakota earning up to 133% of the federal poverty level will be eligible for Medicaid benefits — bringing health care access to more than 40,000 additional people and keeping $328 million in tax revenue in-state every year.

“Since day one, our partners at the Fairness Project have been deeply invested in the effort to finally expand Medicaid for South Dakotans, and this win would not have been possible without them,” said Zach Marcus from South Dakotans Decide Healthcare. “The Fairness Project’s ability to build unconventional coalitions, and their strategic advice, financial support, and dedication to expanding health care access to working people were critical to our success. Now, tens of thousands more families in South Dakota will have access to life-saving health care due to this crucial campaign and the work of the Fairness Project.” 

Until now, South Dakota was one of only 12 states to not expand Medicaid under the Affordable Care Act, despite polls showing a substantial majority supporting the policy. The win also comes in the wake of a transparent attempt to derail the ballot measure process earlier this year. In June, voters rejected a proposal from the state legislature, Amendment C, to raise the passage threshold for most ballot measures from a simple majority to 60% — a transparent effort to block the Medicaid expansion proposal.

“Extremists in the state legislature knew that Medicaid expansion would be incredibly popular, and so they tried to change the rules of the game. Thankfully, they failed, and today we were able to witness the true will of the people: to expand access to health care for the vulnerable, keep rural hospitals open, and bolster the state economy with additional savings,” Kelly Hall said.

With this victory, the Fairness Project marks its seventh successful campaign to expand Medicaid at the state level, having supported all six of successful ballot measures to expand Medicaid in Idaho, Maine, Nebraska, Oklahoma, Missouri, and Utah. Fairness Project campaigns have now extended Medicaid to an additional 900,000 people through these victories.

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