HB 1274 prohibits the delivery or distribution of abortion-inducing medicine, drugs, or substances into South Dakota for purposes of an illegal abortion, with exceptions for self-administration by a pregnant person, life-saving medical procedures, or miscarriage management. It establishes a Class 6 felony for violating this prohibition, imposes civil penalties up to $10,000 per dose, and allows civil lawsuits for wrongful death of an unborn child by specific parties (e.g., parents, the pregnant person, or their estate). The bill directly affects medical providers, pharmacies, and anyone transporting such substances into the state, while exempting individuals acting in self-defense or under medical necessity. The attorney general may seek injunctions to stop violations and collect civil penalties for deposit into a state fund.
HB 1257 redefines "abortion" in South Dakota law to include any action intending to terminate a pregnancy with knowledge it will likely cause the unborn child's death, while excluding specific medical treatments (like miscarriage care, ectopic pregnancy treatment, or procedures to save the unborn child's life). It requires physicians to determine that a pregnancy poses a "reasonably foreseeable risk of death" to the mother before permitting an abortion, mandates attempts to preserve both lives when possible, and mandates hospital-based reporting to the Department of Health. The bill directly affects pregnant individuals, physicians, and hospitals by setting strict medical criteria for legal abortions and prohibiting abortions based solely on psychological conditions or self-harm fears. It does not criminalize all abortions but creates a narrow exception for life-threatening conditions, with violations classified as Class 6 felonies.
HB 1138 requires non-medical home care agencies in South Dakota to obtain a license from the Department of Health before operating. Agencies must submit applications, pay a fee (capped at $100), and verify that home care aides complete 10 hours of mandatory training (covering dementia care, safety, nutrition, and abuse reporting) and pass criminal background checks. The bill directly affects home care agencies, their employees (home care aides), and clients receiving services like bathing assistance, meal prep, or companionship in their homes. Operating without a license is a Class 1 misdemeanor, and agencies must maintain client records and allow department inspections.
South Dakota would join the Physician Assistant Licensure Compact, allowing physician assistants (PAs) licensed in other participating states to practice in South Dakota without obtaining a separate state license. This directly affects PAs - especially active-duty military personnel and their spouses - who can use their existing license from another participating state to practice in South Dakota. The key mechanism is the "Compact Privilege," which permits PAs to provide medical services where the patient is located, while maintaining patient safety through existing state licensing board oversight. This reduces licensing barriers for PAs and improves access to medical care across state lines.
SB 220 directs South Dakota's Department of Corrections to conduct a study evaluating juvenile correctional and residential facilities. The study must examine best practices, therapeutic housing models, vocational training combined with mental health services, and staff-to-youth ratios, including inspections at three facilities outside South Dakota. The bill appropriates $50,000 from the general fund to cover study costs and requires a written report to the Legislative Research Council by September 1, 2026. This is a procedural study bill with no direct policy changes or new requirements for facilities, solely aimed at gathering information for future decisions.
HB 1210 bans employers, schools, state agencies, and other entities from requiring COVID-19 vaccinations as a condition for employment, enrollment, or accessing services. It directly affects workers, students, and individuals seeking public benefits or services. Violating this ban would result in a Class 2 misdemeanor penalty. The law overrides existing requirements and takes effect immediately upon enactment.
HB 1153 protects healthcare providers' right to refuse participation in or payment for medical services that conflict with their moral, ethical, or religious beliefs (Section 2). It applies broadly to all healthcare professionals (like doctors, nurses, pharmacists), healthcare entities (hospitals, clinics), and organizations arranging medical payments (Section 1). The bill prohibits discrimination against providers who exercise this right, engage in protected speech about it, report violations, or disclose conscience-related concerns to authorities (Section 3). It clarifies that employers may accommodate this right through reassignment or schedule changes but cannot retaliate, while not affecting existing duties to provide non-conflicting care.
HB 1212 repeals a provision that previously shielded women from criminal liability for unlawful abortions. It removes the exception that prevented homicide charges when an abortion caused an unborn child's death, making such cases subject to standard homicide laws (Class B felony). The bill directly affects women seeking abortions and medical providers performing them, as it eliminates prior legal protections for abortion-related deaths. Exceptions for lifesaving procedures to preserve the mother's life or spontaneous miscarriages remain unchanged.
This bill appropriates $500 million in federal funds to the South Dakota Department of Health to implement the rural health transformation program, authorized under the One Big Beautiful Bill Act (Pub. L. No. 119-21). It directly affects rural healthcare providers and facilities by funding program implementation. Key provisions include requiring the health secretary to approve vouchers for payments and mandating unspent funds by June 30, 2031, to revert per state law. The bill also declares an emergency to expedite its implementation upon passage.
This bill proposes a constitutional amendment to remove South Dakota's legal requirement to provide expanded Medicaid coverage. It specifically targets Section 10 of Article XXI, which currently mandates that the state provide Medicaid benefits to adults aged 18-65 with incomes at or below 133% of the federal poverty level. If approved by voters, the amendment would eliminate this constitutional obligation, allowing the state to potentially modify or discontinue the expanded eligibility rules. The change directly affects low-income South Dakota adults who currently qualify under the existing Medicaid expansion.
