2026 ballot measure forecast

South Dakota Constitutional Amendment I

Tie Medicaid expansion to federal funding level

Conditions the 2022 voter-approved Medicaid expansion on the federal funding level, letting the state pull back expansion if federal matching funds drop below a set level. The forecast has Yes at 60.4 percent against the 50 percent it needs, a 85% chance to pass.

Likely to passConstitutional amendment referred by the legislatureHealth careUpdated October 22, 2026
Chance to pass
85%
2,000 simulations
Forecast Yes
60.4%
80% range 47 to 73
Needs
50%
a simple majority
Polling average
None
No public polls found
Where the Yes vote lands
needs 50
2035506580
History and structure
60.4% Yes
Polls
None
Forecast
60.4% Yes
Yes leans
Republican
Rule to pass
Simple majority. If Amendment L passes, it is unclear whether it applies to amendments on the same ballot. HJR 5001 (2025).
The campaign

Referred by GOP legislature; no campaign data found.

Constitutional Amendment I by county

Aurora CountyBeadle CountyBennett CountyBon Homme CountyBrookings CountyBrown CountyBrule CountyBuffalo CountyButte CountyCampbell CountyCharles Mix CountyClark CountyClay CountyCodington CountyCorson CountyCuster CountyDavison CountyDay CountyDeuel CountyDewey CountyDouglas CountyEdmunds CountyFall River CountyFaulk CountyGrant CountyGregory CountyHaakon CountyHamlin CountyHand CountyHanson CountyHarding CountyHughes CountyHutchinson CountyHyde CountyJackson CountyJerauld CountyJones CountyKingsbury CountyLake CountyLawrence CountyLincoln CountyLyman CountyMcCook CountyMcPherson CountyMarshall CountyMeade CountyMellette CountyMiner CountyMinnehaha CountyMoody CountyOglala Lakota CountyPennington CountyPerkins CountyPotter CountyRoberts CountySanborn CountySpink CountyStanley CountySully CountyTodd CountyTripp CountyTurner CountyUnion CountyWalworth CountyYankton CountyZiebach CountyMinnehahaPenningtonLincolnBrownBrookingsLawrenceMeadeCodingtonYanktonDavisonHughesUnion
No +30Yes +30Click a county to zoom · arrow keys step through counties by size
Where the margin is won
Pennington County: Yes +8,837Minnehaha County: Yes +7,844Lincoln County: Yes +5,512Meade County: Yes +4,347Codington County: Yes +3,188Lawrence County: Yes +2,783Brown County: Yes +2,745Union County: Yes +1,996Davison County: Yes +1,990Butte County: Yes +1,821Brookings County: Yes +1,701Beadle County: Yes +1,691Yankton County: Yes +1,681Custer County: Yes +1,571Hughes County: Yes +1,565Turner County: Yes +1,366Hutchinson County: Yes +1,275Fall River County: Yes +1,233Hamlin County: Yes +1,126Lake County: Yes +1,076Tripp County: Yes +1,014Grant County: Yes +984Bon Homme County: Yes +936Charles Mix County: Yes +929Walworth County: Yes +873McCook County: Yes +858Gregory County: Yes +822Douglas County: Yes +741Kingsbury County: Yes +728Edmunds County: Yes +727Spink County: Yes +720Deuel County: Yes +699Perkins County: Yes +687Hanson County: Yes +663Brule County: Yes +614Moody County: Yes +587Roberts County: Yes +586Hand County: Yes +585Clark County: Yes +573Haakon County: Yes +569McPherson County: Yes +550Day County: Yes +514Potter County: Yes +512Stanley County: Yes +465Faulk County: Yes +443Aurora County: Yes +438Harding County: Yes +434Sanborn County: Yes +383Lyman County: Yes +349Campbell County: Yes +348Sully County: Yes +322Miner County: Yes +320Marshall County: Yes +312Jones County: Yes +254Jerauld County: Yes +247Jackson County: Yes +223Hyde County: Yes +222Bennett County: Yes +182Corson County: Yes +94Mellette County: Yes +94Ziebach County: Yes +27Oglala Lakota County: No +1,489Todd County: No +651Clay County: No +95Dewey County: No +89Buffalo County: No +61
Yes +76,976 net votes from 61 countiesStatewide Yes +20.7, a 74,591 vote marginNo +2,385 net votes from 5 counties

Projected vote

360,701 votes on the question
ChoiceVotesShare
Yes217,64660.3%
No143,05539.7%
Total360,701100%
CountyYesNoTotalYes share
Minnehaha County42,95435,11078,06455.0%
Pennington County27,99619,15947,15559.4%
Lincoln County17,50611,99429,50059.3%
Brown County8,6565,91114,56759.4%
Brookings County7,3965,69513,09156.5%
Lawrence County7,7314,94812,67961.0%
Meade County8,3173,97012,28767.7%
Codington County7,2544,06611,32064.1%
Yankton County5,4633,7829,24559.1%
Davison County4,8042,8147,61863.1%
Hughes County4,4912,9267,41760.6%
Union County4,5672,5717,13864.0%
Beadle County3,9012,2106,11163.8%
Clay County2,6022,6975,29949.1%
Custer County3,2771,7064,98365.8%
Lake County3,0241,9484,97260.8%
Butte County3,0361,2154,25171.4%
Turner County2,5921,2263,81867.9%
Fall River County2,4201,1873,60767.1%
Roberts County2,0791,4933,57258.2%
Hutchinson County2,2179423,15970.2%
Charles Mix County2,0421,1133,15564.7%
Grant County2,0591,0753,13465.7%
Oglala Lakota County7872,2763,06325.7%
Spink County1,6969762,67263.5%
Hamlin County1,8907642,65471.2%
Moody County1,6191,0322,65161.1%
Bon Homme County1,7828462,62867.8%
McCook County1,6858272,51267.1%
Day County1,4929782,47060.4%
Kingsbury County1,5728442,41665.1%
Tripp County1,6466322,27872.3%
Walworth County1,4906172,10770.7%
Brule County1,3527382,09064.7%
Todd County7171,3682,08534.4%
Deuel County1,3236241,94768.0%
Gregory County1,3805581,93871.2%
Marshall County1,0737611,83458.5%
Edmunds County1,2184911,70971.3%
Hanson County1,1324691,60170.7%
Dewey County7458341,57947.2%
Clark County1,0714981,56968.3%
Hand County1,0284431,47169.9%
Stanley County9554901,44566.1%
Douglas County1,0763351,41176.3%
Perkins County1,0253381,36375.2%
Lyman County8164671,28363.6%
Aurora County7993611,16068.9%
Potter County8082961,10473.2%
McPherson County8252751,10075.0%
Sanborn County69030799769.2%
Corson County54244899054.7%
Miner County65133198266.3%
Bennett County58139998059.3%
Faulk County69525294773.4%
Haakon County75618794380.2%
Jackson County57234992162.1%
Jerauld County54029383364.8%
Sully County53821675471.4%
Ziebach County35933269152.0%
Campbell County51917169075.2%
Mellette County36427063457.4%
Harding County5319762884.6%
Hyde County39917757669.3%
Jones County3509644678.5%
Buffalo County17323440742.5%

Projected 2026 votes: each county's expected turnout, less the roughly 6 percent of voters who skip a ballot question, times its forecast Yes share. The measure needs 50.0 percent Yes to pass.

Polls of the measure

no polls
PollsterSampleEndedYesNoUndecidedYes, adjusted
No public polls of this measure. The forecast rests on how comparable measures have run and how it reached the ballot.
How this is built
Constitutional Amendment I is forecast as a health care measure whose Yes vote leans Republican. Comparable measures from 2018 to 2024 set how far its Yes share moves with South Dakota's partisanship and with each county's 2024 presidential vote, and how it reached the ballot moves it further. Polls then pull the forecast toward them by recency and size, after splitting undecided voters two to one for No. Sources: sdsos.gov, thedakotascout.com. All measures.