PIERRE, S.D. (KELO) — Whether South Dakota expands eligibility for Medicaid to 133% of the federal poverty level is now up to the voters this November.

That’s because the state Senate clearly defined its position on the matter Tuesday with a 23-12 rejection of SB 186.

“I think it’s morally the right thing to do, to take care of the poor,” said Senator Wayne Steinhauer, R-Hartford, the bill’s prime sponsor.

Last year, the same Senate put a measure on the June 2022 primary ballot that, if voters approve, would raise the threshold for measures such as Medicaid expansion to 60%. Steinhauer was one of the 18 who backed the 60% requirement.

Senator John Wiik, R-Big Stone City, led the argument Tuesday against the Legislature passing the expansion. “We want the marketplace, not the federal government, to be in charge of your healthcare,” Wiik said.

Countered Senate Democrat leader Troy Heinert of Mission, “We’re talking about people that need access to healthcare.”

But Senator Lee Schoenbeck, R-Watertown, said Medicaid expansion would drain money that could otherwise flow as state aid to K-12 schools. “It’s not magic,” he said. “We don’t have the printing press they have in (Washington) D.C. — thankfully.”

Schoenbeck engineered the effort last year to put the 60% question on the June ballot so it could be in effect when Medicaid expansion comes up in November.

Senator Reynold Nesiba, D-Sioux Falls, said Medicaid expansion would be “great” for rural hospitals and help some 40,000 South Dakotans. He said people already were paying the Medicaid tax.

Said Steinhauer, “I just suggest, pause and listen to your heart.”