Five Things To know
The 2026 South Dakota Legislative Session is moving quickly, and Week 3 brought no shortage of activity at the Capitol. With hundreds of bills now filed and several key votes behind us, important health care issues are beginning to take shape. Here are five things SDAHO members should know as we head into Week 4.
1. Bills Are Moving Fast
As of Week 3, 485 bills have been introduced at the Capitol. SDAHO is actively tracking 67 measures impacting health care. To stay on top of all of the bills that SDAHO is actively tracking, visit our Bill Tracker, through the SD State Advocacy Webpage.
2. Major Win for Rural Health –
HB 1044, the Rural Health Transformation Fund, was signed into law by Governor Larry Rhoden on Thursday, January 29, 2026, with SDAHO advocacy present at the signing. This new law grants the South Dakota Department of Health spending authority of up to $402 million over two years to support and stabilize rural health care across the state. Because the bill included an emergency clause, it took effect immediately upon the Governor’s signature rather than waiting for the typical July 1 implementation date.
3. Medicaid Expansion Repeal Defeated
HJR 5002, which would have put Medicaid Expansion repeal on the ballot, made it out of committee but failed on the House floor when it did not receive enough affirmative vote. The final vote was (27–39), stopping a significant threat to coverage and access.
4. Ambulance & Nursing Bills Advance
SDAHO has been an active supporter on both HB 1023 and HB 1024, strengthening liability protections and requirements for nurses and ambulance operators. Both measures passed the full senate this week, and now head to the Governor’s desk.
5. Watch List for Week 4
SDAHO is preparing for potential challenges in the week ahead, including legislation related to anti-vaccination policy, medical conscience, property taxes, COVID-19, and a proposal that could repeal the state’s rural recruitment assistance program. As these issues emerge, we may reach out to members to help connect with state lawmakers—particularly those representing your districts and communities.
Check out this week’s SDAHO Advocacy Team podcast which is available to members on on the member portal or by clicking here.
For the latest updates on health care legislation, visit the SDAHO State Advocacy webpage: sdaho.org/state-advocacy.
