South Dakota voters passed a ballot measure to expand Medicaid under the Affordable Care Act, becoming the latest red state to use the method to clear expansion.
Several other states on Tuesday also voted to preserve abortion rights, which an Associated Press survey showed was a key motivating factor for many Democrats.
South Dakota’s ballot approval—which according to the AP won 56% to 43% with 97% of the votes in—will extend Medicaid to nearly 45,000 state residents who currently don’t qualify for such benefits. Advocates hope that other states follow suit in similar ballot measures. There are now 11 states that have not expanded coverage, according to data from the Kaiser Family Foundation.
South Dakota is the seventh state to use a ballot measure to approve the expansion, with advocates using the initiatives to circumvent opposition in Republican-led legislatures. Other states such as Oklahoma have previously faced hurdles in getting the expansion funded by the legislature after the ballot box victories, leading to court battles.
The results come as Congress tried to address the Medicaid expansion coverage gap where people qualify for benefits but live in a nonexpansion state. However, legislation to close the gap was stripped from the Build Back Better Act earlier this year.
Abortion rights win on the ballot
Voters sided with abortion rights across several ballot measures Tuesday night. A measure to add abortion rights to the state constitution passed in Michigan with 55% of the vote.
Another ballot measure to install abortion restrictions in Kentucky went down, with 52% of voters striking it, according to The New York Times. Voters in Kansas overwhelmingly struck down a similar measure earlier this year.
Voters in Vermont also approved a ballot measure to enshrine abortion rights in the state’s constitution by a whopping 72% to 21%.
A nationwide AP survey, which included questions crafted by the Kaiser Family Foundation, showed that more than half of Democratic voters and younger women say the Supreme Court’s decision to overturn a constitutional right to abortion was a big impact on their decision. The most important issue for voters though was inflation increasing costs, while a quarter of voters pointed to the overturning of Roe v. Wade.