South Carolina

SC Democrats say Medicaid expansion is being blocked. So they want voters to decide

Democrats are pushing for S.C. voters to decide in a statewide referendum whether Medicaid should be expanded in the Palmetto State.

Since the federal government allowed states to expand their Medicaid programs eight years ago, Democrats have clamored for the Palmetto State to add more residents to the program’s rolls.

Republicans, who control the S.C. Legislature and Governor’s Mansion, consistently have opposed expansion. They argue adding more South Carolinians to the joint federal-state health care program for the poor and disabled would be too expensive, even with federal subsidies.

However, if a bill introduced in the state Senate this week becomes law, voters will have a chance to decide if South Carolina accepts Medicaid expansion in 2020.

“We continue to have tens of thousands uninsured,” said state Sen. Brad Hutto, D-Orangeburg, one of nine Senate Democrats backing the measure. “It continues to be a problem in rural areas. Hospitals have people show up in the emergency room who could easily be covered by Medicaid.”

Voters would have to decide if Medicaid should be expanded to cover individuals 65 years of age or younger whose incomes are at 138 percent of the federal poverty level or lower — $16,753.20 for an individual or $34,638 for a family of four — in line with the standards spelled out in the Affordable Care Act, or “Obamacare.”

Up to 312,000 additional South Carolinians would be eligible for the expanded program, according to the Center on Budget and Policy Priorities and HealthInsurance.org.

However, letting voters decide on Medicaid expansion will be an uphill climb.

The GOP-controlled Legislature would have to approve putting the question on voters’ November 2020 ballots. If voters did approve a change, Gov. Henry McMaster also would have to act to accept federal money for the expansion.

While both the GOP-controlled Legislature and Republican McMaster oppose expansion, Democrats hope it will be more difficult for the Republicans to refuse to let voters decide the issue.

“I’d be surprised if we were not going to adhere to the will of the people,” Hutto said.

Hutto noted that on Election Day this year, voters approved Medicaid expansion in Idaho, Nebraska and Utah — three Republican states.

McMaster has said expanding Medicaid would cost S.C. taxpayers $1 billion, arguing there are better alternatives. Those include promoting the use of telemedicine and loosening the restrictions on nurse practitioners so they can do more to improve the health of rural South Carolinians.

“Yes, health care is a problem,” McMaster said during a June 20 televised GOP primary runoff debate. “We don’t need the centralization that came from Obamacare. We have to get the free enterprise involved in it. We will be better off.”

State officials have estimated expanding Medicaid would have cost the state between $1.1 billion and $2.3 billion during the first six years of the expansion — or from $183 million to $383 million a year.

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Bristow Marchant is currently split between covering Richland County and the 2020 presidential race. He has more than 10 years’ experience covering South Carolina. He won the S.C. Press Association’s 2015 award for Best Series on a toxic Chester County landfill fire, and was part of The State’s award-winning 2016 election coverage.
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