5 Things to Know
The 2026 legislative session has officially wrapped up, and while it began with an unprecedented number of anti–health care proposals, the outcome was ultimately positive for South Dakota’s health care community. Thanks to strong advocacy efforts from SDAHO and our Government Relations partners, many harmful bills were stopped and several important health care priorities moved forward.
Here are five key takeaways for SDAHO members:
1. The Session by the Numbers
Lawmakers introduced 673 total bills this session. SDAHO closely tracked 88 bills, supporting 17, opposing 17, and monitoring 54 that could impact health care providers across the state.
2. Modest Medicaid Provider Increase in State Budget
The final state budget sets the general fund at $2.54 billion with a 1.4% increase for Medicaid providers, schools, and state employees. For health care providers, this represents $27.6 million in total funds, along with additional support tied to a new methodology change designed to hold critical access hospitals harmless during implementation.
3. Progress on Workforce and Licensure
Several measures passed to support the health care workforce. Interstate licensure compacts advanced for physician assistants, respiratory care professionals, and athletic trainers, helping improve workforce mobility. Two additional bills strengthened ambulance workforce capacity by clarifying requirements and liability protections for nurses serving on ambulance crews and updating ambulance operator requirements.
4. Rural Health Transformation Up and Running
The Rural Health Transformation Project received spending authority early in the session, allowing work on this major initiative to move forward.
5. Major Defensive Wins for Health Care
A large portion of the session involved stopping proposals that could have negatively impacted health care delivery. Lawmakers ultimately defeated several anti-vaccination and COVID-related bills, along with proposals that would have repealed property tax exemptions for health care facilities, restricted health care property agreements in underserved areas, and placed Medicaid expansion back on the ballot.
The Legislature will return to Pierre on March 30 for Veto Day to consider any gubernatorial vetoes.
A full overview of the legislation tracked this year is available through SDAHO’s 2026 Bill Tracker.
To view the final Legislative Update Podcast: Week 9, featuring SDAHO’s Advocacy Team, click here.
