Guest Column: Congress Must Draw The Line At Medicaid Cuts for South Dakota by former State Sen. Jean Hunhoff

Recent discussions around funding for Medicaid have left South Dakotans like myself worried that access to healthcare is on the chopping block. Many throughout our state are highly worried that potential cuts will put their care at risk. Even The New York Times has featured how South Dakota would be “especially stuck in Congress cuts Medicaid.”

Thankfully, our congressional delegation has made clear how important Medicaid is in South Dakota. Senator Thune noted in April that Congress must “get it done right” and that they would “do the right thing” when it comes to preserving Medicaid benefits. Senator Rounds has protected critical programs by pushing back on proposals that would recklessly change federal funding, pointing out, “That’s not a cost-cutting measure—it’s a cost transfer.” I thank our leaders on Capitol Hill for recognizing the stakes at hand and representing South Dakota. Our state needs them to continue standing firm on this issue.

I served in the South Dakota Senate. I know how difficult budget allocations can be. Many factors come into play as our government attempts to be as cost-effective as possible while protecting the good programs our people count on. But there comes a point during budget cuts when a line must be drawn for key programs, a line that cannot be crossed or dire consequences will follow. For the good of so many South Dakotans, lawmakers must draw that line at Medicaid, Medicare and Social Security.

South Dakota is responsible for the resources that support our state’s share of Medicaid. With this duty, our state has labored to keep the program in line with the needs of our population and meet federal and state requirements for Medicaid eligibility. If sweeping Medicaid cuts go through, as many as 25 million people nationwide could lose health coverage, including about 10 million children and three million rural residents.

South Dakota would be hit especially hard, as we are home to large rural, veteran and disabled populations and other vulnerable patients who lean on this important program especially heavily. Seven of the top 20 rural counties for seniors enrolled in Medicaid are right here in South Dakota. In these counties, among seniors, Medicaid enrollment rates get as high as 66 percent of the total senior population. And overrepresented in rural counties is our Native American population, which is already badly underserved.

Medicaid is more than a safety net for these remote areas in our state— it is a lifeline, ensuring hardworking American families get the care they need. The program is also crucial for South Dakotans in the final stages of their lives. More than half of all nursing home residents in our state rely on Medicaid for care.

Another group that relies on Medicaid is young families— especially pregnant mothers and newborn babies. Two in seven South Dakota children are covered through the program, and around 40 percent of babiesborn in our state receive coverage through Medicaid in their first year of life. South Dakota is sadly second in the nation for highest infant mortality rate. Medicaid is critical in the fight against this epidemic in our state, covering the care that our newborn babies need. Congress cannot risk these populations’ health or worsening this crisis to achieve other political goals.
Outside of public service, I’ve worked with patients for more than 30 years as a registered nurse. I have seen firsthand how South Dakotans from all walks of life need Medicaid for care. I cannot imagine the distress that would fall upon patients, healthcare administrators and other critical care providers if Medicaid were cut.

Many care facilities in our state, especially those in rural areas, treat patients on Medicaid and rely on the program to assist our communities. We have seen so many rural hospitals, long-term care facilities, nursing homes and care centers dedicated to serving vulnerable patients close in recent years. I cannot imagine the closures and devastation to our healthcare infrastructure if these cuts to Medicaid went through.

If Medicaid funding were reduced, more care would be left uncovered and critical facilities would be underpaid— especially in our state, where rural health facilities rely on Medicaid-covered care to stay afloat. Costs would shift, jeopardizing these providers and leaving patients stuck searching for coverage from limited insurers and private payment options. These are significant considerations for our state legislature, as we want to ensure taxpayers and health providers have the most effective and cost-efficient options to operate and cover quality healthcare.

President Trump himself has repeatedly stated that these programs should not be touched. Medicaid, in large part, provides care to the voter base of our current Presidential Administration and Republicans’ majority in Congress. Our elected officials must not turn their backs on the basic needs of the very working-class voters who gave them their mandate.

Members of Congress must listen to the President and to their own constituents. Medicaid cuts are not what South Dakota wants or needs. I encourage our leaders to stand strong against Medicaid cuts and ensure Medicaid benefits are here to stay for all who need them.

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Jean M. Hunhoff was a Republican member of the South Dakota Senate from 2021 to 2025. She also served in the South Dakota House of Representatives representing the 18th district from 2001 to 2007 and again from 2015 to 2021. She previously served in the South Dakota Senate from 2007 to 2015. Hunhoff was the mayor of Yankton from 1995 until 1997. Hunhoff earned her BSN from South Dakota State University, her MSN from the University of Nebraska Medical Center, and her MHA from the University of Minnesota Medical School. Hunhoff was honored recently as the longest-serving female member of the South Dakota Legislature in South Dakota history.