The Affordable Care Act has been the central issue in the government shutdown.
It's also the target of Republican candidates who want to take Senator Tim Johnson's Senate seat in 2014.
"I will lead the fight to repeal and replace Obamacare," Sioux Falls Doctor Annette Bosworth said when she announced her run for U.S. Senate in July.
Dismantling the Affordable Care Act, known as Obamacare, has become a rallying cry for replacing South Dakota's blue seat in the Senate with a conservative.
"You have to take it apart piece by piece the way it was originally built. You have to talk about where the funding is coming from," Republican U.S. Senate candidate Mike Rounds said.
But as of October 1, South Dakotans can sign up for coverage under the Affordable Care Act.
By the time next year's election rolls around, thousands will be covered under the new plans.
"There were a lot of efforts when Medicare was passed and became a law to repeal it, defund it, ended up being a pretty good program," Rick Weiland said.
Weiland is the only Democrat in the race and thinks there is no turning back on the Affordable Care Act. While he thinks some changes still need to be made, he says the program is here to stay.
"The Affordable Care Act is law. If there are problems, and I'm sure there will be, I would like to see a public option and allow people to buy into Medicare, we should work that through the legislative process and negotiation and compromise and then let the majority rule," Weiland said.
When it comes to the conservatives in the race, like former Governor Rounds, he says his opposition to the law hasn't changed and he will continue to campaign to get rid of it.
"The best way to take the Affordable Care Act, Obamacare, apart is to take it apart piece by piece by piece and replace it with a good plan based upon the open market," Rounds said.
Other Republicans in the race say the fact that the law is already being implemented is why conservatives on Capitol Hill are fighting so hard to stop it right now.
"I absolutely do believe it will be more and more difficult as it becomes embedded," Republican U.S. Senate candidate Larry Rhoden said.
Conservatives in the U.S. Senate race say voters have not heard the end of the cries to repeal it. Some even say opposition may grow.
"Obamacare is a complete failure, or will prove to be a complete failure, at a time when we'll add trillions to our national debt," Rhoden said.
"That it is under a place called the IRS, the Supreme Court ruled the way this is Constitutional is a tax, so now the IRS gets that data. The least trusted arm of our government gets the data. That's the part where I say no," Bosworth said.
"I don't see that trend changing. I think the current trend that we're seeing is going to continue and that is that people are seeing the adverse affects of the enactment of Obamacare and they're reacting accordingly," Republican U.S. Senate candidate Stace Nelson said.
All stances Weiland will be campaigning against as the election gets closer and as the Affordable Care Act continues to be enacted.
"We should be fixing what's not working as we discover what's not working well, just like we had to do with Medicare, just like we had to do with Social Security," Weiland said.
But whether it’s simply fixing or completely dismantling, South Dakota voters will likely still have a clear choice at the ballot box even eleven months after the beginning of Obamacare.