The vote came as a Democratic amendment to an alternative health care bill. The amendment would have expanded Medicaid to South Dakotans earning up to 133 percent of the federal poverty line, $15,521 for an individual or $31,721 for a family of four.
Under the Affordable Care Act, the federal government would pay for 90 percent or more of the cost of the Medicaid expansion. That means South Dakota would pay just a few million dollars right away for some $200 million in federal aid, though South Dakota's share would rise above $30 million by 2020.
Democrats said that tradeoff was something lawmakers couldn't refuse. They also cited a study saying that infusion of federal dollars would boost South Dakota's economy, and thus lead to millions of dollars in extra tax revenue.
Republicans split into two camps. Some opposed any possibility of Medicaid expansion, saying the deficit-spending federal government can't afford new spending.
Other Republicans said they were open to Medicaid expansion, but only if South Dakota gets flexibility from the federal government to design its own expansion. That's Gov. Dennis Daugaard's position as well.
