South Dakota GOP advances Medicaid work requirement bill

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South Dakota Republican lawmakers on Monday advanced a proposed constitutional amendment that would allow the state to try and force people on Medicaid to work despite federal policy prohibiting such requirements.

The proposal would change the state constitution and would need voter approval in 2024. All 11 Republicans on the House State Affairs Committee voted Monday to advance the legislation to the full House. The panel's two Democrats voted against it.

South Dakota voters in November approved expanding Medicaid eligibility to people making 138% of the federal poverty level.

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Republican Rep. Tony Venhuizen of Sioux Falls, who's sponsoring the legislation to allow the state to require people to work for Medicaid benefits, said it could push them to find jobs. Key proponents of providing Medicaid to more people argued it would undermine expansion before it has even been implemented.

A bill that would require Medicaid recipients to work has passed a committee in the South Dakota House.

The federal government bars states from requiring work for Medicaid eligibility, but Venhuizen said that could change. The proposed state constitutional amendment would allow voters to decide, he argued.

"I think they see the value in work and in incentivizing work for people who are able," Venhuizen said.

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But organizations that supported Medicaid expansion last year said such a requirement fails to account for people who can't keep a job due to disabilities. It would also be costly and difficult to police, said Deb Fischer-Clemens, a lobbyist for Avera Health and several other health care groups.

The Trump administration tried to impose work requirements for public programs, but states that implemented the requirements were challenged in federal courts.

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A federal judge ruled that work requirements created numerous obstacles for poor people trying to get health care, which federal and state officials failed to evaluate or resolve adequately.