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 Senate passed HB1044 on January 28, 2026 by a vote of 32 to 2. 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 and workforce development are not the proper role of government. Rather, these matters should be handled by the free market and private charity—not federal subsidies and state-administered programs.
