Wyoming? Really? Why not South Carolina? - SC Small Business Chamber of Commerce

The State
December 7, 2014

By Frank Knapp Jr., Guest Columnist

Columbia, SC — Wyoming is negotiating with the Obama administration to draw down federal dollars to provide affordable, private health insurance to its low-income citizens who earn too little to qualify for premium assistance under the Affordable Care Act. These uninsured Wyoming citizens fall into that state’s coverage gap.

Wyoming?

Yes Wyoming, the bastion of libertarianism. The same Wyoming that doesn’t have an individual or corporate income tax. The same Wyoming that the Tax Foundation has ranked in the past as having the single most “business friendly” tax climate of all 50 states. The same Wyoming that has a Republican governor and a solidly Republican legislature.

Yes, that Wyoming.

And it’s not just Wyoming’s Republican Gov. Matt Mead who wants to pull down federal dollars to close its state health insurance coverage gap. The Republican governors in Indiana, Tennessee and Utah are also negotiating with the White House. They want their states to join nine other Republican-led states that have already expanded their low-income health insurance programs (i.e., Medicaid) thanks to Obamacare. Nineteen other states have done the same.

Commenting on the Wyoming plan now being pitched to Washington, Gov. Mead said, “We have done the work and we have a plan. I believe it is the most favorable plan for Wyoming, and it addresses the needs of those who fall in the gap.”

So what about South Carolina’s coverage gap that has swallowed up over 200,000 of our low-income citizens? Over half of these uninsured are working. Nearly 10,000 are veterans. Forty-seven thousand are between the ages of 50 and 64.

Where is South Carolina’s Republican plan to tap the federal dollars to not only address the health care of our citizens in need but also boost our economy by bringing $4.7 million a day into our state? One study projects these funds would result in 44,000 new jobs. Closing our coverage gap would certainly create a healthier workforce for our businesses while controlling health-care costs for those already insured individually or through their employers.

Until now there has been only one word from our Republican Gov. Nikki Haley and our Republican-controlled Legislature about closing our coverage gap with the help of federal dollars — NO.

But State House sources are now saying that the Haley administration is looking at an Alabama model for reforming our state Medicaid program. Alabama has recently established private, non-profit regional care organizations that will receive funding from the state’s Medicaid agency and be responsible for providing health care to all Medicaid-eligible citizens in their service area. The expectation is that these RCOs will help constrain escalating Medicaid costs and provide fiscal certainty to the state.

Even more significant than this effort to “privatize” its Medicaid program is Alabama’s next step. According to Mike Horsely, the president of Alabama’s Hospital Association, his Republican-led state is on the verge of asking the Obama administration for the federal health-care dollars Wyoming, Indiana, Tennessee and Utah are also officially seeking.

Exactly how Alabama intends to use additional federal money to help its uninsured, low-income citizens is not clear. However it doesn’t appear to be the same “private option” used or intended to be used by the other Republican states. The “private option” uses the additional federal dollars to purchase private health insurance for low-income citizens through the Health Insurance Marketplace.

The “private option” would be a better method of using new federal funds to provide coverage to low-income, uninsured South Carolinians. However if the State House sources are correct, we should applaud the Haley administration for considering the Alabama model but only if it leads to infusing the state with the additional federal money needed to close our coverage gap.

Mr. Knapp is the president and CEO of the South Carolina Small Business Chamber of Commerce. He can be reached at fknapp@scsbc.org.