The South Dakota Department of Social Services is seeking public comment on its Medicaid work requirement waiver.
To qualify for Medicaid expansion coverage, people must have a job, be enrolled in school or job training, or be the parent or caregiver of a dependent child or disabled individual.
For the next 30 days, the Department of Social Services is taking input on eligibility requirements and exemptions. Exemptions include physical and mental disability, pregnancy, or people residing in areas of low-employment opportunities.
The department will verify work compliance during a person’s annual Medicaid renewal.
Social Services Secretary Matt Althoff said the department is approaching Medicaid work requirements like it does for food assistance.
“Work is a fundamental component of that too. We hope that you would see that we see that as an opportunity for South Dakotans to achieve fulfillment—to derive a greater sense of innate purpose they were given," Althoff said. "That’s the core objective of what we’re trying to do.”
In 2024, voters amended the state’s Medicaid expansion provision to include adding work requirements.
After the first year of implementation, DSS officials anticipate a decrease in enrollment of the roughly 30,500 individuals enrolled in Medicaid expansion. They anticipate it to drop by about 500 people. They say that’s either due to folks finding a job that lifts them out of Medicaid eligibility, or by failing to meet requirements for the health coverage.
The comment period comes as congressional Republicans are working to write Medicaid work requirements into federal law.
Current work requirement proposals in federal legislation differ slightly from the state’s proposed waiver.
Heather Petermann is the director of Medical Services within DSS. She said there’s a lot of uncertainty, but the department is moving forward.
“Until we know for sure what language is included in the federal legislation—for example, the draft language does include references to things like, ‘the provisions from the federal legislation cannot be waived,’" Petermann said. "We don’t know whether that means state could or couldn’t have something that is more or less restrictive as long as it has the same components. We don’t know yet.”
The state is also accepting written comments on the proposed waiver. An additional forum is scheduled for June 12 in Sioux Falls.
To comment on the waiver, click here.
