HB1044 appropriates federal funding to carry out the state's Rural Health Transformation Program and declares an emergency so the money can be used right away. The bill authorizes South Dakota to spend federal funds on rural healthcare projects, including efforts to recruit healthcare workers, modernize rural facilities, and expand access to care.
The South Dakota State House of Representatives passed HB1044 on January 26, 2026 by a vote of 56 to 11. We have assigned pluses to the nays because this legislation accepts federal funds for purposes not authorized by Article I, Section 8 of the U.S. Constitution. Federal funding almost always comes with strings attached, eroding state sovereignty and violating the 10th Amendment. Furthermore, healthcare, workforce development, and expanding access to medical services are not the proper role of government. Rather, these matters should be handled by the free market, private charity, and local communities—not federal subsidies and state-administered programs.
