Five Things To know
Week 4 of the 2026 South Dakota Legislative Session was especially active—and challenging—for health care. More than 600 bills have been filed to date, with SDAHO tracking 85 measures, most requiring defensive advocacy. Here are five key takeaways for members:
1. HB 1153 Raises Serious Concerns
HB 1153, the “medical conscience” bill, would create overly broad protections for providers, hospitals, and long-term care facilities. While SDAHO supports balanced protections for individual beliefs, this bill would create operational, legal, and access-to-care challenges—especially for rural facilities. Avera Health is neutral on this bill.
It’s important to note, protection already exists. Hospitals have long-standing policies that allow employees to request exemptions from specific services based on moral, ethical, or religious beliefs—while still ensuring patient care. These policies comply with Title VII federal non-discrimination law. SDAHO has urged lawmakers to vote NO.
2. Several Problematic Bills Failed
This week included notable legislative wins for health care, with multiple concerning bills failing to advance, including measures related to ivermectin and hydroxychloroquine protocols, a change in the scope of practice for midwives, in addition to distance of a birthing center and staffing requirements, and consent requirements for ovum or sperm donation.
3. On the Governor’s Desk
HB 1023 – establish requirements and liability protection for registered nurses and licensed practical nurses serving on ambulance crews and HB 1024, modify requirements for ambulance operators, were both delivered to the Governor’s desk this week – for final passage. A win for those impacted by both pieces of legislation.
4. Anti-Vaccination Bills have now been filed.
Several anti-vaccination bills are expected to be heard in the House next week. SDAHO is coordinating closely with its Public Policy Council and Government Relations team and will oppose measures that threaten public health and patient safety.
5. Key Senate Bills to Watch
SDAHO will oppose SB 161, which would repeal an exemption for certain health care facilities, and support SB 233, addressing limits on administrative fees or penalties related to out-of-network care.
For the latest updates on health care legislation, visit the SDAHO State Advocacy webpage: sdaho.org/state-advocacy.
