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Post-Election Medicaid Expansion Outlook

South Dakota voters approved a constitutional amendment to extend Medicaid eligibility to adults below 138 percent of the federal poverty level — increasing coverage for more than 40,000 state residents beginning July 1, 2023. Residents, with support from hospitals, providers, patient advocates, and others, championed the ballot initiative through grassroots efforts.

Attention now turns to the 11 states yet to expand Medicaid, of which only Florida and Wyoming permit ballot initiatives. For the remaining holdout states, the state legislative process could offer a potential path toward Medicaid expansion.

In Kansas, reelected Gov. Laura Kelly (D) stated that she is determined to expand Medicaid after facing hurdles from the Republican-controlled state legislature in her first term. North Carolina Gov. Roy Cooper (D) had overwhelming bipartisan support for Medicaid expansion in 2022, with both chambers passing versions of a Medicaid expansion bill.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Faridat Animashaun is a policy associate at America's Essential Hospitals.

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