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SD Among States Where Republican Lawmakers Want Voters to Alter or Scrap Medicaid Expansion

Lawmakers want voters to shift expansion from state constitutions to statute and add work rules, with Missouri Democrats warning it could enable defunding.

  • Republican lawmakers in Missouri, Oklahoma, and South Dakota are seeking to alter or scrap constitutional amendments that expanded Medicaid, setting the stage for potential rollbacks in upcoming elections.
  • Residents in these three states previously voted to amend their constitutions to expand Medicaid under the Affordable Care Act, covering adults under 65 earning $22,024 or less.
  • Missouri Republicans propose adding work requirements and deleting language prohibiting "greater or additional burdens or restrictions," while Oklahoma and South Dakota seek to end expansion if federal funding falls below 90%.
  • Fairness Project executive director Kelly Hall called the moves "abhorrent," while Oklahoma Council of Public Affairs director Curtis Shelton argued it is fair to ask voters to reconsider given program costs.
  • Nationally, forty-one states have expanded Medicaid eligibility under the ACA, with Utah already having laws to automatically roll back coverage if the federal contribution dips below 90%.
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15 Articles

Nebraska ExaminerNebraska Examiner
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Republican lawmakers in 3 states want voters to alter or scrap Medicaid expansion

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stateline.org broke the news on Wednesday, April 22, 2026.
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