SIOUX FALLS — South Dakota’s first responders have joined the campaign to expand Medicaid in the state, officially endorsing the passage of Constitutional Amendment D at the ballot box this November.
The South Dakota EMS Association and the South Dakota Firefighters Association, which represent first responders in South Dakota, gathered virtually Tuesday afternoon to jointly announce their support of the ballot question, which would require the state provide Medicaid services to low-income individuals between the ages of 18 and 65.

According to Sandy Frentz, former public health manager for the City of Sioux Falls, the ballot question has multi-faceted benefits that go beyond simply providing healthcare to more South Dakotans.
“Medicaid expansion will make South Dakotans healthier and our economy stronger,” Frentz said. “It delivers affordable healthcare options to people working hard at jobs that don't offer insurance and brings our tax dollars back home to create jobs, grow our economy and strengthen rural hospitals and healthcare systems, as well as first responder services.”
Frentz said the program wouldn’t cost the state much, as the vast majority of funding would come from federal monies, returning over $1 billion of federal taxes paid in by South Dakotans.
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“Federal funding will pay for 90% of expansion costs, with the state of South Dakota responsible for the remaining 10%,” Frentz said. “Expanding Medicaid means South Dakota will save more than $63 million in general funds in the first two years alone as result of additional funding from [American Rescue Plan Act] programs. Medicaid expansion would also return more than $1.3 billion tax dollars to South Dakotans from Washington, D.C. over a five-year period.”

Amy Marsh, a 30-year volunteer in emergency medical services (EMS) and vice-president of the South Dakota EMS Association, focused on how the expansion could change the landscape of rural healthcare for both providers and first responders.
“Rural hospitals and healthcare providers work hard to keep their doors open in our communities, and our communities struggle to recruit and keep good healthcare providers, making it harder for those residents to access the healthcare they need,” Marsh said. “Rural areas need Medicaid expansion to make it more likely that people will have a hospital and healthcare providers in their community that they can trust.”
With more options for local healthcare, Marsh said rural residents would no longer have to take “long drives” to receive care from providers in larger cities.
A firefighter and EMT in Viborg, Charlie Kludt, president of the South Dakota Firefighters Association, echoed Frentz and Marsh, adding that rural first responders — which are oftentimes volunteer services who provide the first medical services to patients — will see benefits, as well.

“The emergency service that will most directly benefit from Medicaid expansion is EMS, and we believe it’s important, the financial assistance that Medicaid expansion will provide, will help ensure a strong EMS for those communities,” Kludt said. “We believe that Medicaid expansion will be beneficial to our fellow emergency services agencies and continued care for those South Dakotans that need it.”
After roughly 10 minutes of Frentz, Marsh and Kludt sharing what they expect from Medicaid expansion, the group fielded no questions from the roughly dozen — including media — attending the virtual gathering and concluded with a singular message: get out and vote.
“The passage of Constitutional Amendment D will provide important financial protection to hardworking individuals with chronic conditions, provide coverage for critical healthcare services and will help ensure that care that people need remains affordable and remains in rural communities and places where people are living,” Frentz concluded. “Supporting a healthier South Dakota and a healthier community can be done by voting ‘yes’ on Amendment D this November.”
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This year’s general election lands on Tuesday, Nov. 8.