This joint resolution proposes an amendment to the South Dakota Constitution that would condition the expansion of Medicaid on the federal medical assistance percentage remaining at or above ninety percent. If approved by voters in the next general election, the amendment would allow the state to provide Medicaid benefits to individuals aged eighteen to sixty-five whose income is at or below one hundred thirty-three percent of the federal poverty level, plus an additional five percent for family size, starting July 1, 2023. The coverage provided must meet or exceed federal benchmark requirements, and the state cannot impose stricter eligibility criteria than those applicable to existing Medicaid recipients, although a work requirement may be implemented for eligible individuals who are not disabled.

Additionally, the resolution mandates that the South Dakota Department of Social Services submit necessary state plan amendments to the federal government by March 1, 2023, to facilitate the implementation of this amendment. The state is also required to take all necessary actions to maximize federal funding for medical assistance under this provision. The amendment includes a severability clause, ensuring that if any part of it is found invalid or unconstitutional, the remaining provisions will still be enforceable.