Constitutional Amendment I: Conditioning the Requirement of Expanded Medicaid on the Level of Federal Medical Assistance
November 3, 2026 · South Dakota · Statewide
How do we calculate vote impact?
Vote impact = representation (how much weight one vote carries here, the smaller the district's population, the higher the representation) + decisiveness (how likely this race is to be close, based on past results and number of candidates).
Representation: High · 89 out of 100
Smaller districts give each vote more weight, and this district is small for its type. About 907,428 people live here.
score = 100 × ln(largest population ÷ this district's) ÷ ln(largest ÷ smallest), rounded to 2 decimals = 100 × ln(39,287,377 ÷ 907,428) ÷ ln(39,287,377 ÷ 582,397) = 89.47, comparing all statewide districts nationwide (grades: 66+ high, 33+ average, otherwise low)
Ballot measure: +1 step
Your vote sets the policy directly, so the rating gets a one-step boost.
High representation + a ballot-measure boost → Very high vote impact.
Ballot Measure
Healthcare Affordability (against), Social Programs and Welfare (against)
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.
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.
Read the official measure text (PDF)
Source: sdlegislature.gov
Source: sdsos.gov
Source: sdsos.gov
Election sources
Source: sdsos.gov
Source: sdsos.gov