By Ashley Heffernan, contributing writer | Goose Creek resident Jerry Marsh retired from the restaurant industry as a general manager about nine years ago as his multiple sclerosis started getting worse.
Now in a wheelchair, the 62-year-old works part-time and qualifies for Medicare and Social Security Disability Insurance.
His $36,000-a-year salary also supports his wife, who gets subsidized health care coverage through the Affordable Care Act, and their 12-year-old grandson, who they adopted three years ago and are raising.
The child qualifies for Medicaid, which provides health coverage to more than a million South Carolinians, including about 662,000 children.
President Donald Trump’s proposed FY 2018 budget, released earlier this week, would cut about $610 billion from Medicaid over the next decade. Presidential budgets, however, are a first step in the federal government’s annual funding dance. Congress, which long has supported Medicaid, will have the final say on the health program used by one in five South Carolinians.
Still, Marsh worries about the possibility his grandson could lose coverage.
“We’d have to choose between that and eating,” Marsh said. “It would create a tremendous hardship financially on us.”
Marsh said he has been upset since first hearing that Trump and the GOP-majority Congress intended to repeal and replace the Affordable Care Act, but threatening to also cut Medicaid funding could become a life-or-death situation for his family.
“It angers me, because they don’t understand how important this is,” he told Statehouse Report.
Medicaid is currently jointly funded by the federal government and the states, with poor states receiving a higher percentage of federal funding than wealthier states. The federal government pumped more than $5 billion into South Carolina in FY 2017 to cover Medicaid recipients, while the state government contributed nearly $1.3 billion.
Trump’s budget, titled “A New Foundation for American Greatness,” says Medicaid “inadequately serves enrollees and taxpayers” and “must be reformed to allow states to manage their own programs.”
The budget proposes giving flexibility to states in one of two ways. Either there would be a pot of money sent to states based on a per-capita cap through which states would get a fixed amount of federal funds per enrollee, regardless of actual health care costs. Or states could choose to receive a block grant and get one large pot of money – again, a fixed amount – but decide how to allocate it.
No comment yet from the state, but repercussions could be major
The S.C. Department of Health and Human Services declined to comment on the proposed budget until it is finalized.
Christian Soura, who was director of the department before leaving in early April and is now vice president of policy and finance at the S.C. Hospital Association, said it’s too soon to know how South Carolina would manage its own program. However, Soura said, he has never seen a proposal from any state that would allow it to maintain the same levels of access and care for the same populations while using less money.
“If we see Medicaid cuts that are in the neighborhood or look something like maybe even 20 percent over the course of the next decade or so, it is very difficult to see how you can take that much money out of a program that is built to serve the needy and the disabled and the most vulnerable members of our society without there being very serious, real-world repercussions for the health and welfare of the people affected,” he said.
Shelli Quenga, director of programs at the Palmetto Project, said if Trump’s proposed cuts to Medicaid were implemented, South Carolina could fare worse than other states because of its low median income.
“We are a state that gets more from the feds than we put in,” said Quenga, whose nonprofit organization advocates for more access to health care. “Because we’re such a poor state, we don’t have the tax base to put in as much money compared to what we get back in terms of Medicaid from the feds.”
Without a tax base to make up the difference, she said the only answer would be to cut health care services.
“It would mean pitting pregnant women against disabled people against elderly people trying to fight for scarce dollars,” Quenga said. “There’s not enough dollars to divvy up to provide the coverage that we need.”
Business could be hurt, too
Cuts to Medicaid could also have a negative impact on the state’s economy and ability to recruit new business, according to Steve Skardon, executive director of the Palmetto Project.
“If we just thought of it on economic terms, how do you have a workforce that’s productive and appealing to potential employers if they’re not well? Chronic disease is huge in this state,” Skardon said. “What employer, if they know a huge percentage of their employees are going to have chronic disease, is going to come here? It makes no sense whatsoever.”
Similarly, United Way of the Midlands CEO Mac Bennett said productive, working citizens need health care, education and financial stability.
“Whether it’s employer-provided health insurance that gives you access or government programs or military or whatever, we think the more people we can cover, the more stable, the more successful our population is going to be,” Bennett said. “Any cuts are going to handicap us even further.”
Federal officials have mixed feelings
South Carolina’s congressional delegation appears to have mixed feelings about the president’s Medicaid proposal.
“Medicaid should work as it was originally designed– to serve as a safety net for our most vulnerable and not as a disincentive for millions of able-bodied Americans to work,” said U.S. Rep. Tom Rice, a Republican representing South Carolina’s 7th District. “I agree with President Trump that our health care system needs reforms to help bend the cost curve. Initiatives like medical liability reform and giving states more control in how they manage their Medicaid funding will help accomplish this goal. Congress will continue to work on its own budget and, in the end, draft and pass our own proposal.”
On the other hand, U.S. Rep. James E. Clyburn, a Democrat representing the 6th District, called the proposal “cruel and mindless.”
“The massive Medicaid cuts in Trumpcare and Trump’s proposed budget would have disastrous impacts for South Carolina and communities across the country,” said Clyburn, the third highest-ranking Democrat in the U.S. House. “Not only disabled and impoverished individuals would be impacted, but rural hospitals and nursing homes everywhere could be devastated.”
It ain’t over ‘til it’s over
U.S. Rep. Joe Wilson, a Republican representing the Midlands, declined to comment directly on the proposed Medicaid cuts. Instead, he emphasized the president’s budget is, at this point, just a proposal.
“Congress has the constitutional power of the purse,” he said,” and I look forward to working with my colleagues and local organizations that provide services to responsibly spend taxpayer dollars.”
Meanwhile, Jerry Marsh continues to fret.
“There’s a lot that our president does that I’m worrying about,” he said,” and that’s just the latest.”
- Have a comment? Send to: feedback@statehousereport.com.
We Can Do Better, South Carolina!
Let’s not allow this legislation to pass.
We need to be proactive.
Everyone send a letter of objection on the same day to their District Representative even though the House passsed the Bill.
Also mass letter the same day to Senators Graham and Scott objecting to anything but Single Payer as the only way to rest every American for all the care they’ll ever need.
We can not Single out one demographic against another and continue to focus on American values.
Single Payer is the solution, BUGSY for it and never discuss Health Care again.
Pingback: BRACK: Guys need to buy clothes that fit — Charleston Currents
There are no cuts to Medicare nor Medicaid. They simply aren’t getting increases other then what is mandated by law. There is no money being cut. Just because you don’t get an increase doesn’t mean it’s a cut. This is scare tactics at it’s worse.
Single payer is a disaster in most places it’s being used. Many of the socialist counties that have it have also decided to allow private insurance as well to allow coverage for those that can afford it. Many people are paying for the private because their care is better under private than public, single payer.
Thank you for your opinion. There are plenty of studies that show single-payer is the best system.
Andy, Thank you for your opinion but you and your studies aren’t factoring in choice nor timing. Cost is still cost no matter who pays and when. If you are accepting of the fact that the government decides where and when you get healthcare , well enjoy it. Months waiting for mri tests? Months on a waiting list for simple procedures?
Would you like me deciding where and when you can go to a Doctor? Guess what? I don’t like you having that power either.
Instead of the socialist route lets fix the cost problem first. Let’s have competition across states lines. Let’s increase the risk pool so policies become affordable in smaller states where the pools are too small to accommodate risk and make it affordable for most.
Liking single payer just because others like it doesn’t make it a good plan. It’s not. Never will be. Many government plans are now allowing private insurance for those people willing to pay.
I prefer my choice over government dictates.
http://www.nationalreview.com/article/446689/canada-single-payer-health-care-system-failures-cautionary-tale
Andy, This story wasn’t about single payer but so called funding cuts.