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Contrary to Moore/AFP Claim, Medicaid Expansion Doesn’t Force People Off Private Insurance

Americans for Prosperity propagandist Keith Moore (who knows a thing or two about living large on government handouts) contends on the 2022 Ballot Question Pamphlet that expanding Medicaid via Amendment D will force South Dakotans off private insurance and into Medicaid.

The idea that Medicaid expansion crowds out private insurance was trotted out by Affordable Care Act opponents and largely debunked before the ACA’s Medicaid expansion took effect. Current coverage numbers do not indicate any major loss of private coverage. According to the Kaiser Family Foundation’s figures, states that have expanded Medicaid have on average only 0.4% less of their populations covered by employer plans and 0.7% less covered by non-group private plans than states that have not expanded Medicaid. But overall, expansion states have an average uninsured rate of only 7.6% compared to 10.3% in non-expansion states.

A KFF review of research finds seventeen studies showing no clear effect of Medicaid expansion on private coverage rates. Six studies showed a negative effect, while two studies showed a positive effect. KFF notes that the few declines shown in research “may occur if individuals previously covered through employer-sponsored or self-pay insurance opt in to Medicaid given Medicaid’s typically lower out-of-pocket costs and more comprehensive benefit packages….” Amendment D does not require anyone to drop coverage and enroll in Medicaid. If you like your over-priced, under-covering private insurance, you can keep it. You can even be on private insurance and Medicaid at the same time.

The proper responses to Moore/AFP’s complaint about losing private insurance are thus (1) “False!” and (2) “Who cares? Medicaid expansion covers lots of people who aren’t covered now and means overall more South Dakotans can get better coverage and access to health care without going broke.”


  1. O 2022-10-25 13:08

    Larry, I object to the use of “best.” Lax and best are not synonyms.

  2. P. Aitch 2022-10-25 15:21

    Cory says, “You can even be on private insurance and Medicaid at the same time.” I.E. Kaiser is private insurance and over a third of Kaiser members are covered by Medicaid. I read it in my annual Kaiser Medicare handbook. PS – Kaiser insurance saved my life in 2002. Blue Cross coverage was denying me and killing me until my employer switched me to Kaiser.

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