By Bill Davis, senior editor | Looks like “conventional wisdom” was wrong, or at least delayed, when it came to health care in South Carolina.
In 2014, conventional wisdom held that when Gov. Nikki Haley led South Carolina to “opt out” of Medicaid expansion funded through Obamacare, it was merely a political move. Some health care advocates hoped that after a few years, the state would buy-in to expansion because of billions of dollars offered by the federal government.
Two years down the line, there has been little movement in state government to expand the state health care program, despite a vexing “coverage” gap between Obamacare and the state’s program that left tens of thousands without the real possibility of health insurance.
According to several observers and experts on state health care, able-bodied residents making between 70 percent and 100 percent of household poverty wages are not covered by either the state or the federal health care programs.
The U.S. Department of Health and Human Services recently released information that more than 80,000 South Carolinians suffering from mental health and addiction issues would “benefit” from expanded Medicaid.
The federal government has offered states 100 percent of the funds it would take states to cover Medicaid expansion until 2017, when the buy-in would begin to shrink 5 percent every year. Past estimates of those in South Carolina caught in this coverage gap, overall, has ranged from ranged between 200,000 to more than 700,000.
The new conventional wisdom
Conventional wisdom now has it that nothing will be done until after the November elections when everyone in the Senate is safe for a couple of years.
Holley Ulbrich, an economist at the Strom Thurmond Institute at Clemson University, argues that “nothing happens in this state happens until the January right after the Senate is reelected.” She pointed to 1990 when the legislature passed legislation creating special local option sales taxes as the “most upstanding example.”
That doesn’t mean state Sen. Joel Lourie (D-Columbia) is going to take it sitting down this year.
An insurance broker and consultant not running for reelection, Lourie has vowed to argue for expansion when proposed budget bills hit the floor of the Senate in coming weeks.
“I’m not overly optimistic, as something this big has got to start with the governor,” said Lourie. “For me it’s not just a fiscal issue, but a moral one, too. A lot is said from the podium in the Senate about faith. But there is nothing in my faith, or in the Judeo-Christian value system, about leaving these people behind.”
Often, he said, potential customers, especially working single mothers, walk into his office intent on buying health insurance, only to find they are in that coverage gap.
“The working poor are getting screwed, there is no other way to say that … maybe they’re ‘getting the short end of the stick’ would be more diplomatic,” Lourie fumed.
Lourie’s isn’t the only voice in the Senate passionate about the issue. State Sen. Kevin Bryant (R-Anderson), a pharmacist and chairman of the General Committee, has been a consistent foe of expansion and Obamacare.
This week, Bryant confirmed his opposition, saying the state must “break the cycle of dependency” on the taxpayers’ wallets.
State Sen. Tom Davis (R-Beaufort), also a foe, introduced a bill this week that could enhance residents’ ability to “shop” for better health care coverage.
The bill would, in part, require insurance companies to “share” as much as 40 percent of cost-savings with patients who comparison-shopped.
“The idea is to give consumers a chance to take control of their health care costs by making the prices transparent for health care services, rewarding consumers who shop for savings, and introducing market forces to lower costs and increase options,” said Davis, a frequent champion of the free market over government action.
The S.C. Hospital Association thinks it’s time that the legislature did something to address the coverage gap, according to its executive vice president Allan Stalvey.
Stalvey said a majority of the 31 states that expanded Medicaid with federal buy-ins have reported generally positive fiscal impacts.
Ulbrich, who also holds a degree in theology, said, “This is the rare instance where what is fiscally-prudent coincides with the morally-justified path of action.”
Stalvey said that programs in Southern states like Arkansas and Kentucky have shown that state-funded, privately-managed hybrid expansion of Medicaid could also work in South Carolina.
In fact, the hospital association commissioned a study that found exactly that, said Stalvey, who added, “But why take our word for it?”
As such, the association is backing an effort in the House to set aside a chunk of state money and study it before the next legislative session. “Who can argue against a study?” asked Stalvey.
Bryant said he would have to “study very closely” any call to take taxpayer money for such a study.
“Well, then,,” replied Stalvey, “hire a conservative firm like Arkansas did; a very conservative firm.”
We Can Do Better, South Carolina!