Medicaid Work Requirements in South Dakota
South Dakota Medicaid Expansion adults ages 19 to 64 must show at least 80 hours a month of work, job training, community service, or school starting January 1, 2027. DSS asks for more information only when its data cannot confirm you.
Check your situation in South Dakota
When it starts in South Dakota
- August 2026: a community engagement fact sheet was mailed to all Medicaid Expansion recipients.
- September 2026: DSS began notifying affected enrollees.
- January 1, 2027: new applicants, and members at their first 2027 renewal, must meet the rule. Renewals move to every 6 months.
Who has to meet it
The rule applies to people ages 19 to 64 in the Medicaid adult expansion group, unless they are pregnant, have Medicare, or are exempt. You meet it in a month with 80 hours of work, community service, a work program, or school (in any mix), by going to school at least half-time, or with at least $580 in monthly income.
You are exempt if, for example, you care for a child 13 or younger or a person with a disability, are pregnant or postpartum, are American Indian or Alaska Native, are medically frail, are a veteran with a total (100%) VA disability rating or TDIU, were in foster care at 18 and are under 26, are in drug or alcohol treatment, meet SNAP or TANF work rules, or left jail or prison in the last 3 months. See the full exemption list.
Court ruling, October 29, 2026. In Massachusetts v. Oz, a federal court struck down the CMS rule's extra "significantly impairs" test for the medically frail exemption. If you are in any of the five medically frail groups in the law, you qualify. The January 1, 2027 start date did not change, and CMS may appeal. What the ruling means.
How South Dakota checks and how to report
Months checked: At application on or after January 1, 2027, and at your first 2027 renewal.
Check your status through DSS notices or the BEES Customer Portal and ask your local DSS office if you have questions.
Other things to know in South Dakota
- DSS told its board in April 2026 that of 29,504 expansion enrollees, 6,066 could not be confirmed as exempt or compliant from data, and about 1,213 could be disenrolled "if we do nothing."
- DSS said it does not yet collect data on volunteer service, medical frailty, or veteran disability status, so people in those groups may need to report.
- South Dakota withdrew its own work requirement waiver proposal after the federal law passed.
Official tools and contacts
- Report and upload: BEES Customer Portal
- Medicaid Recipient Hotline: 1-800-597-1603
- SD DSS: H.R. 1 changes
- Agency: South Dakota Department of Social Services (DSS)
Federal protections that apply in South Dakota
- The state must check its own records before asking you for proof.
- If it can't confirm you meet the rule, you get a notice and at least 30 days to respond, and your coverage continues meanwhile.
- You get written notice and the right to a fair hearing before coverage ends, and you can reapply at any time.
- If you lose Medicaid for not meeting the rule, you cannot get marketplace premium tax credits for those months. Learn more.
Frequently asked questions
When do Medicaid work requirements start in South Dakota?
January 1, 2027. Current members are usually checked at their first renewal on or after that date.
How many months does South Dakota check?
At application on or after January 1, 2027, and at your first 2027 renewal.
How do I report my hours or an exemption in South Dakota?
Check your status through DSS notices or the BEES Customer Portal and ask your local DSS office if you have questions.
Who do I call about South Dakota Medicaid work requirements?
Medicaid Recipient Hotline: 1-800-597-1603
Can I lose South Dakota Medicaid right away if I don't meet the requirement?
No. Federal law requires a notice, at least 30 days to show you comply or are exempt, continued coverage during that time, and fair hearing rights before coverage ends.
Sources
- SD DSS: H.R. 1
- SD DSS: Medicaid phone list
- KOTA (Apr. 27, 2026)
- Public Law 119-21 (H.R. 1), sec. 71119: community engagement requirement (GovInfo)
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- Massachusetts v. Oz, No. 1:26-cv-12962-RGS (D. Mass.), memorandum and order (Oct. 29, 2026)