COLUMBIA, S.C. — Health officials and lawmakers are calling on the South Carolina General Assembly to join all but ten states in the nation in expanding Medicaid under the Affordable Care Act (ACA).
Health care reform advocates from Cover SC, a coalition that advocates for Medicaid expansion, were joined by two North Carolina lawmakers responsible for passing expansion in call on the state to close the health care coverage gap, where individuals fall who do not make enough to qualify for a government health care subsidy but make too much to qualify for Medicaid in the state right now.
Under the ACA, states can expand Medicaid coverage for all adults below 138% of the federal poverty level. For a family of three, parents earning less than $35,632 would qualify, and all adults, regardless of household size or disability, according to Cover SC.
North Carolina Republicans pass expansion, saying it costs the state nothing
Medicaid expansion went into effect in North Carolina in December, after a bill steered in part by Rep. Donny Lambeth and Senator Kevin Corbin, two republican lawmakers. The federal government pays for 90% of the costs of Medicaid expansion, while the state has to only put up 10%. But under their version of the bill, hospital associations pay for the other 10% not covered by federal funding.
"There is no state funding," said Rep. Lambeth. "If you structure the program correctly and you work with your hospitals, you can get the hospitals to pay your state share."
Clint Arnold from Bradley, South Carolina lost his job due to health issues in September of 2022, and needed a kidney transplant shortly after. He was able to get one but has had more health complications since then, all without health insurance. He said he was making too much from his disability checks to qualify for Medicaid, so when MUSC had the treatment he needed, he couldn't afford it.
"I’ve lost my ability to walk and I actually might have that ability back if I could have that back surgery," said Arnold.
Supporters of expansion say South Carolina is sending tax payer dollars to other states by not tapping into the federal funding for expansion
Over $1 billion would come to South Carolina in state funding under the ACA if Medicaid is expanded. Without expansion, South Carolinians are still paying federal taxes that fund Medicaid programs across the country. Expansion supporters say that's only sending South Carolina tax dollars to other states.
"We’re talking about something that is 90% paid for by the federal government," said Sen. Tom Davis, who proposed a committee to look at health care reform, including Medicaid expansion, and report back the findings to the General Assembly. He says he's not sold on expansion, but that it's something lawmakers need to look at.
"The fact that we don’t accept that money doesn’t mean that we’re saving any money on the deficit in the federal level. That money just gets allocated to other states and so we’re leaving on the table a billion dollars every year that could be going to health care services in South Carolina," said Sen. Davis.
Governor McMaster vetoed the proviso to create the health care study committee, and has staunchly opposed expansion. He said Wednesday he'd rather see the money go towards finding jobs for those who can't afford health care.
"This expansion would only address childless, able-bodied adults," said McMaster. "We are spending hundreds of millions of dollars to provide programs for training, for access to information, for a variety of things to help people find good paying jobs that they're qualified for. I’d rather put money into that than putting money into something for childless able-bodied adults. We have jobs for them."