Constitutional Amendment I failed in the November 3, 2026 election, with 131,187 Yes votes (44.2%) and 165,391 No votes (55.8%), according to unofficial results from South Dakota Secretary of State.
The election office reported 671 of 671 precincts reporting.
Full results
| Choice | Votes | Share |
|---|---|---|
| No (won) | 165,391 | 55.8% |
| Yes | 131,187 | 44.2% |
What the measure does
South Dakota already offers expanded Medicaid coverage to some adults with low incomes. The federal government currently pays 90% of the expansion’s cost. This would end that expanded coverage if federal funding dropped below 90%; coverage would then return to the groups named in the state explanation, including children, pregnant women, disabled people, and older people.
What the result means for Sioux Falls
A no vote means the Constitution stays as it is. Expanded Medicaid coverage would not end under this amendment if federal funding fell below 90%.
What happens next
These results are unofficial. They become final when election officials certify them at the canvass, and totals can still change a little as remaining mailed and provisional ballots are counted.
Every race in Sioux Falls is on our election results page, and every measure is explained on the ballot measures page.
