Healthcare Policy
South Dakota Healthcare Policy 2026
Medicaid expansion status, ACA coverage, uninsured rates, and how healthcare shapes the 2026 elections in South Dakota.
Yes
Medicaid Expanded
9.2%
Uninsured Rate
30,000
ACA Marketplace Enrollees
Federal
Exchange Type
Key Healthcare Provisions
| Medicaid Expansion (ACA) | Yes |
| Reproductive Healthcare | Banned |
| Mental Health Parity | Limited parity |
| Drug Pricing Policy | Not regulated |
Healthcare System Overview
South Dakota voters approved Medicaid expansion (Amendment D, 2022, 56% yes) against the wishes of Gov. Kristi Noem, who opposed it. Around 42,000 South Dakotans have gained coverage. The expansion took effect in 2023.
2026 Political Impact
Kristi Noem opposed Medicaid expansion while running for president. South Dakota voters approved it anyway, showing the gap between leadership and voters on healthcare access.