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Constitutional Amendment I: Conditioning the Requirement of Expanded Medicaid on the Level of Federal Medical Assistance

South Dakota

My vote power

Above average

Election date

November 3, 2026

How do we calculate my vote power?

What goes into the rating for ballot measures: Representation: how much weight one vote carries here compared with a statewide vote — the smaller the district, the more each vote counts. You have more power in ballot measures because you vote directly on the policy.

Representation: Average · 50 out of 100

This district covers a large share of its state, so each vote carries about average weight — like a vote in a statewide race. About 907,428 people live here.

Show the representation math

score = 50 + 50 × ln(state population ÷ this district's) ÷ ln(50,000) = 50 + 50 × ln(907,428 ÷ 907,428) ÷ ln(50,000) = 50, measured against a statewide vote in SD (grades: 66+ high, 55+ above average, 33+ average, otherwise low; a statewide race is the 50 baseline)

Average representation + a direct vote on the policy → My vote power: Above average.

Ballot Measure

Opposes: Healthcare Affordability, Social Programs and Welfare

Today South Dakota's constitution requires the state to provide expanded Medicaid coverage. Amendment I adds a condition: the state must keep that coverage only while the federal government pays at least 90 percent of its cost. If the federal share ever drops below 90 percent, the state could end or cut back expanded Medicaid.

Read the official ballot measure (PDF)

A YES vote means

A yes vote lets the state end or cut expanded Medicaid coverage if the federal government's share of the cost falls below 90 percent.

A NO vote means

A no vote keeps the constitutional requirement to provide expanded Medicaid no matter how much the federal government pays.

Sources: sdlegislature.gov · sdsos.gov2

Source: sdsos.gov