South Carolina proposes Medicaid changes for low-income parents

Desmond Milligan · August 19

COLUMBIA, S.C. (WSPA) — A request by state leaders could change Medicaid coverage for thousands of low-income parents across the Palmetto State.

In late June, Governor Henry McMaster asked Secretary of Health and Human Services Robert F. Kennedy and the federal government for permission to adjust Medicaid eligibility through the Section 1115 waiver.

To be eligible, the plan would require a person to work or be enrolled in approved educational program for at least 80 hours a month.

“It’s a half step in that direction of helping out some people who need help,” said David Anderson, an Assistant Professor at the Department of Health Services Policy and Management at USC.

For years, many South Carolinians have fallen into what’s called “the coverage gap,” meaning they earn too much to qualify for Medicaid, but not enough to afford insurance on the federal marketplace.

In a letter, McMaster expressed optimism about the request.

“Granting South Carolina the authorities necessary to reinstitute this initiative will strengthen the Medicaid program’s dual missions of financing health services and improving opportunities for independence, self-reliance, and prosperity for the state’s citizens,” he wrote.

“People have a very hard time predicting exactly how many hours that work and how those hours actually show up and then record them correctly because one thing we have to remember, low wage work is sometimes very unpredictable,” Anderson continued.

Sue Berkowitz with the South Carolina Appleseed Legal Justice Center said that requirement could do more harm than good. She said she has lots of questions for the Governor.

“I would ask him to spend a day or two with impacted people and see what barriers are in front of them before you put these barriers up because if you truly believe that healthcare is important for work, then let’s talk about how you make it work,” she said.

Anderson said South Carolinians who qualify and maintain eligibility are much better off.

“We know from the Oregon Medicaid Experiment that health insurance coverage immediately produces substantial mental health gains,” he said. “It produces substantial financial protection.”

The waiver was filed in late June and the federal government is currently reviewing it; experts said a decision could take several more months.

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