Serving South Dakota

Health Insurance in South Dakota

Compare your South Dakota coverage options with a licensed advisor. Individual, family, self-employed, and small business plans, marketplace subsidies, and enrollment help, explained in plain language.

Licensed in South Dakota

Verifiable credentials, NPN 21610992.

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How It Works Here

How Health Insurance Works in South Dakota

South Dakota residents have several coverage paths, from marketplace plans and subsidies to private options and employer coverage. Whether you are self-employed, raising a family, or running a small business, clear guidance on how coverage works in South Dakota is the first step toward a plan that fits.

South Dakota Marketplace

South Dakota uses the federal Health Insurance Marketplace at HealthCare.gov. Individual and family plans are compared and enrolled through the federal marketplace or directly with private carriers.

Subsidies & Tax Credits

South Dakota has expanded Medicaid, so more lower-income residents may qualify for Medicaid coverage. If your income is above that threshold, income-based marketplace subsidies (premium tax credits) can lower your monthly cost.

Open Enrollment

Open enrollment for South Dakota plans generally runs November 1 through January 15. Qualifying life events, like losing coverage, marriage, or a new baby, open a special 60-day window any time of year.

Licensed Guidance

Jordon Murphy Health is a licensed advisory firm serving South Dakota residents. We help you compare options, understand costs, and enroll with confidence, at no cost to you.

South Dakota Medicaid Expansion

Three Votes, One Question: How South Dakota Keeps Deciding Medicaid Expansion at the Ballot Box

South Dakota is one of just three states — alongside Missouri and Oklahoma — that put Medicaid expansion directly into its state constitution through a voter-approved ballot measure rather than an ordinary statute. That choice made the expansion unusually durable, but also unusually exposed to direct democracy: South Dakota voters have now been asked about Medicaid expansion three separate times in four years — to create it in 2022, to open the door to work requirements in 2024, and to potentially unwind it in 2026.

Enshrined in the Constitution

South Dakota voters placed Medicaid expansion directly into the state constitution in November 2022, passing Amendment D by a 56%-44% margin (56.21% to 43.79% on certified returns), with coverage taking effect July 1, 2023. That made South Dakota the third state — after Oklahoma (2020) and Missouri (2020) — to expand Medicaid through a constitutional amendment rather than an ordinary statute the legislature could revise on its own. Because the expansion sits in the constitution in all three states, unwinding it requires going back to voters rather than a simple legislative vote. Source: healthinsurance.org/medicaid/south-dakota, corroborated by Georgetown University's Center for Children and Families and MultiState policy analysis.

Enrollment Trails the Original Estimate

When South Dakota's Medicaid expansion launched on July 1, 2023, federal officials projected it would extend coverage to more than 52,000 residents. Enrollment has consistently come in under that mark: about 28,000 people had enrolled by October 2024, the state's own revised target of roughly 40,000 by 2025 wasn't met either, and actual enrollment stood at about 29,600 as of June 2025. Source: CMS.gov press release, 'South Dakota Expands Medicaid Bringing Health Coverage to More than 52,000 State Residents' (June 30, 2023); healthinsurance.org/medicaid/south-dakota.

Voters Opened the Door to Work Requirements

In 2024, South Dakota voters approved Amendment F by the same 56%-44% margin, giving the legislature authority to impose work requirements on Medicaid expansion enrollees. That authority remains dormant: a work requirement cannot take effect without a federal Section 1115 waiver, and the state's related waiver request — pending with CMS since 2018 — still has not been approved. Source: healthinsurance.org/medicaid/south-dakota.

A 2026 Vote Could Unwind It

On the November 3, 2026 ballot, Amendment I asks South Dakota voters whether to repeal expanded Medicaid coverage if the federal government's funding share for the expansion population ever drops below its current 90% level. It's the third time since 2022 that Medicaid expansion itself has gone before South Dakota voters. Oklahoma lawmakers advanced similar legislation in early 2026 that would have put the same question to Oklahoma voters, but it stalled before reaching a statewide ballot — so South Dakota's Amendment I is, as of this writing, the only measure of its kind voters are actually deciding in 2026. Source: South Dakota Public Broadcasting, 'AG releases final ballot explanations for 2026 constitutional amendments' (May 20, 2026); MultiState policy analysis.

Who We Help in South Dakota

Coverage Guidance for Every South Dakota Situation

We serve South Dakota residents across Sioux Falls, Rapid City, Aberdeen, Brookings, and Watertown and statewide.

Common Questions

South Dakota Health Insurance FAQ

Could South Dakota's 2026 ballot measure repeal Medicaid expansion?

It's on the ballot, but nothing is decided yet. On the November 3, 2026 ballot, Amendment I asks South Dakota voters whether to repeal expanded Medicaid coverage if the federal government's funding share for the expansion population ever drops below its current 90% level. Even if voters approve it, repeal would only trigger if federal funding actually drops, not automatically. We track this ballot measure and help clients understand what it would mean for their coverage and what options exist if their situation changes.

Where do I buy individual health insurance in South Dakota?

South Dakota uses the federal Health Insurance Marketplace at HealthCare.gov. Individual and family plans are compared and enrolled through the federal marketplace or directly with private carriers. We help you compare both marketplace and private options and choose the one that fits your doctors, prescriptions, and budget.

Can I get a subsidy on South Dakota health insurance?

Many residents qualify for income-based premium tax credits that lower monthly costs. South Dakota has expanded Medicaid, so more lower-income residents may qualify for Medicaid coverage. If your income is above that threshold, income-based marketplace subsidies (premium tax credits) can lower your monthly cost. We check whether you qualify and help you set an accurate income estimate.

When is open enrollment in South Dakota?

Open enrollment for South Dakota plans generally runs November 1 through January 15. Qualifying life events, like losing coverage, marriage, or a new baby, open a special 60-day window any time of year.

Do you help self-employed people and small businesses in South Dakota?

Yes. We work with South Dakota individuals, families, self-employed professionals, and small business owners across Sioux Falls, Rapid City, Aberdeen, Brookings, and Watertown and statewide, matching each situation to the right coverage.

Get Clearer Direction on South Dakota Coverage

Talk through your options with a licensed advisor who serves South Dakota. No cost, no pressure.