Quarterly Advocacy Update: Summer 2026

As we get into the summer season, the SDAHO Advocacy Team has several topics that are top of mind, including the primary results, gubernatorial run-off, and another summer study on EMS in South Dakota. As of July 1, we saw legislation from the 2026 session go into effect, including new Medicaid hospital payment methodologies, an 18-month claims denial and recoupment window, and additional interstate licensure compacts for physician assistants, respiratory therapists, athletic trainers, and social workers.

Federal Advocacy

Last summer at this time we were following the final language of the One Big Beautiful Bill, which included funding for the Rural Health Transformation Program. This summer we will be following the continued rollout of this process, with plans to meet with our federal delegation in the fall regarding the impact these dollars are making on health care in South Dakota. Please reach out to Jacob.Parsons@sdaho.org if you have any feedback as you go through the application, notification, or award stages of the process. We also continue to monitor the upcoming work requirements that will take effect January 1, 2027, as a part of the same package.

State Advocacy

The biggest thing happening in Pierre this summer for health care is the Emergency Medical Services Funding Task Force. While there was a summer study last year regarding Emergency Medical Services in South Dakota, this task force is specifically looking at funding and reimbursement in this space. The first meeting took place on June 17 and set the stage for monthly meetings this summer to investigate how local EMS providers are billing, various insurance rates for private and public payors, regionalization models, and more. The SDAHO Advocacy Team anticipates the opportunity to provide public input throughout the process and work with legislators to help determine a path for sustainable EMS into the future.

In addition to that task force, the Department of Human Services is doing another review of the nursing home rate methodology. Justin Hinker, VP of Post-Acute care is SDAHO’s lead representative in that process. One of the main discussion points thus far has been looking at the potential for increased rates for facility maintenance and repair, as many of our nursing homes in South Dakota are continuing to age. Look for summaries from this workgroup as we enter the fall and winter editions of our Advocacy Update. We will also continue to monitor all other interim committees in the capitol and rules packages as they have impact on the health care space.

2026 Election Update

The June primary brought the potential for a positive change in the legislature for health care. As you may recall, these last two years we have faced many challenges with a growing group of Republican legislators who often voted against the more traditional republican group of legislators. There was also a shift in leadership amongst the House of Representatives, which led to a House Health Committee that voted against good health care policy on almost every bill on an 8-5 vote. Through this year’s primary, however, we’ve seen a shift back to more traditional republicans being nominated to move forward into the primary. All eight of the legislators on the House Health committee who continuously voted against good health care policy will not be on the November ballot.

Additionally, we saw a gubernatorial primary race where no candidate reached the 35 percent minimum threshold to be placed on the November ballot. When this happens in South Dakota, the top two vote receiving candidates go into a run-off election, which will take place on July 28. Current Governor Larry Rhoden has proven to be a friend to health care during his time as a legislator, and as the current Governor has had an open door for discussions with our health care leaders. The other candidate, Toby Doeden, is unknown how he will work with our health care leaders. His goal of cutting property taxes in South Dakota without creating a new funding source has the SDAHO Advocacy Team worried, as history has shown that when the State or Legislature needs large sums of ongoing funding, the first target is usually the Medicaid budget. Absentee voting is open in South Dakota we highly encourage all our members that are registered to vote in the run-off do so between now and July 28.

What’s Next

The SDAHO Advocacy team will continue to monitor the SD legislature during the interim with Jacob Parsons, Director of Advocacy and Reimbursement, located in Pierre, and the full Advocacy Team will monitor changes at the federal level. If you have any questions about what is included in this update, or anything else related to SDAHO’s Advocacy efforts, please reach out to Jacob at Jacob.Parsons@sdaho.org.