South Dakota: Medicaid enrollment up 15.7% since COVID hit; 27K would gain coverage via #ACA expansion

South Dakota

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources. For South Dakota, I'm using estimates based on raw data from the South Dakota Dept. of Social Services for January 2021 and beyond.

South Dakota is one of 12 states which still hasn't expanded Medicaid eligibility under the ACA (13 if you include Missouri, whose voters expanded the program last year...but which the state legislature refuses to fund).

South Dakota's non-ACA Medicaid enrollment hovered between 100,000 - 110,000 people from 2014 - 2020...but since the COVID pandemic hit in early 2020, it's increased by 15.7%.

In addition, according to the Kaiser Family Foundation, there's 27,000 uninsured South Carolina residents who would become newly eligible if the state were to expand Medicaid under the ACA, including 16,000 currently caught in the "Medicaid Gap" (those who earn less than 100% of the Federal Poverty Level, thus disqualifying them for ACA exchange subsidies either) and another 11,000 uninsured who qualify for a subsidized private healthcare policy but who haven't enrolled in one so far.

In addition, KFF estimates around 2,000 uninsured SD residents who are already eligible for the program but who haven't signed up as of yet.

South Dakota has around 887,000 residents according to the 2020 U.S. Census. As of April 2021, around 119,000 of them were enrolled in Medicaid, or 13.4% of the state population.