What it means to vote NO on Amendment I and L in South Dakota

Welcome! 

Now through November 3, 2026 (Election Day), South Dakota voters will have the opportunity to protect healthcare and future efforts to pass public health initiatives by voting “No” on Amendment I and Amendment L.  

Amendment I would undermine Medicaid expansion by ending coverage for thousands of South Dakotans if federal funding changed. A vote NO would keep the South Dakota Constitution unchanged and preserve Medicaid expansion as approved by voters in 2022.  

Amendment L seeks to require future proposed constitutional amendments or revisions to meet a 60% threshold for passage rather than a simple majority. If the measure were to pass, it would significantly raise the barrier for advancing public health protections—including efforts to expand access to care or enhance tobacco control and prevention—through the ballot process. Similar measures failed in 2022 and 2018. 

South Dakotans believe in hard work, personal responsibility, and taking care of our neighbors. Medicaid expansion supports these values by helping people stay healthy, remain employed, and access care close to home. A vote no on Amendment I and Amendment L would keep the South Dakota constitution unchanged and preserve Medicaid expansion as approved by voters in 2022.  

ACS CAN encourages South Dakota voters to oppose Amendment I and Amendment L now through Election Day on November 3rd.  

Get involved and sign the petition.

Share how Medicaid has impacted you or someone you know. 

Learn more about how and where to vote.  

Paid for by the American Cancer Society Cancer Action Network. www.fightcancer.org.