More than a decade after the Affordable Care Act was signed into law, it’s still there, believe it or not 12 states That refuses to accept Medicaid expansion. In theory, South Dakota residents would be able to lower that total to 11 via the ballot box in the fall. In practice, it’s a little more complicated than that.
Even in states where elected officials have held off Medicaid expansion, health care advocates have, in several cases, managed to circumvent politicians by pushing the issue through polling referendums. In South Dakota, supporters were unable to persuade the Republican-led legislature to adopt the policy many of its neighbors have, so they succeeded in putting Medicaid’s expansion on the ballot in 2022.
There is certainly no guarantee of success: South Dakota is quite conservative, and persuading a majority of the state’s electorate to support politics—in an election year that is potentially tough for progressive candidates and causes—is a real challenge.
But for Republicans in the state, that clearly wasn’t challenging enough. Dana Milbank of the Washington Post explained in modern column:
…Republicans in the South Dakota legislature have come up with a new solution: They are moving to enshrine minority rule in the state constitution. Even worse, they are trying to force their constitutional amendment to minority rule by holding the vote on the day only hardcore Republican voters are expected at the polls.
To appreciate the brazenness of GOP lawmakers’ scheme, it is worthwhile to elaborate.
Under the status quo, polls in South Dakota work the same way they do in every other state: if a measure is endorsed by a majority of voters, it is passed.
What the South Dakota Republicans – and their partners In the Koch-funded Americans for Prosperity program – they did, however, come up with a shift in the success criterion. Under the Republican Party’s C Amendment, the state constitution would be amended to require an overwhelming 60% majority for ballot procedures that would include any policy requiring more than $10 million in government spending over five years.
In other words, the point would be to rig the election in the fall to make success in the Medicaid expansion nearly impossible.
To help ensure the success of Amendment C, and the failure of the Medicaid expansion, the same South Dakota Republicans chose tomorrow for a reason. Milbank added:
The South Dakota Republican-controlled legislature put its amendment to kill Medicaid’s expansion on the ballot on June 7, the state’s primary election day. Since nearly all contested primaries are…on the Republican side, this essentially stacks votes so Democrats and independent voters don’t even cast their ballots.
Part of what makes this so extraordinary is seeing how far some GOP policymakers are willing to go to prevent thousands of struggling families from getting health care coverage. But in a political dynamic like this, there is an equally indefensible extra layer.
Democratic Senator Troy Heinert He said Amendment C was part of a “systematic assault on the will of the people.” This is true and important.
There is compelling evidence that many Republican policymakers see democracy as a nuisance and that electoral defeats are grounds for concocting outlandish conspiracy theories. But the South Dakota scheme is a classic of this kind: state voters may have made a responsible choice in a free and fair election, so GOP officials scrambled to make sure the election would be less fair.
Even a Republican lawmaker admitted that his partisan colleagues were acting in “Iman Sei. They shrugged and proceeded anyway.
If Amendment C passes, which sounds like a safe bet, it would be an exaggeration to say Medicaid expansion sure will not pass. After all, when Idaho voters approved the policy four years ago, it passed with 61 percent of support. If health care backers in South Dakota can reach a similar total this fall, Medicaid expansion will pass despite GOP efforts to subvert democracy.
But the possibilities are not great. In this battle, the more South Dakota Republicans win, the more families will number and the more their democracy will be lost.