The biggest excuse South Carolina officials continue to use for not accepting federal dollars to expand healthcare to 123,000 low-income, uninsured working South Carolinians, those who earn too much to be eligible for our state Medicaid program but not enough to qualify for premium assistance under the Affordable Care Act, is cost to the state.
There are 19 states, including South Carolina, that still refuse to take the federal dollars. Had they done so in 2014 when first available, these states would have had 100% of the cost of expanding their Medicaid programs covered by the feds. Then starting in 2017 the federal dollars would have been gradually reduced until 2020 when the feds would cover 90% of the cost of the program forever.
Obviously South Carolina has missed the boat for 3 years of 100% federal funding. Since cost has been the only reason given by state officials for rejecting the federal dollars, this loss of 100% funding will be used by opponents for continuing to reject providing affordable healthcare to our deserving citizens.
But now with Louisiana’s recent decision to take the federal dollars to help their citizens, things might be changing. That state is going to expand its Medicaid program effective July 1, 2016. The result nationally will be that over 50 percent of the low-income American’s that are eligible to be covered under this effort will now have affordable health insurance.
So President Obama announced this morning that he wants to sweeten the deal for the 19 outlier states. In his Fiscal Year 2017 budget President Obama will propose that these states will be able to have 3 years of federal dollars to cover 100% of the cost of expanding their Medicaid programs and have the same phase down period in funding until it reaches 90%.
With the experience of other states showing that providing affordable health insurance to their low-income citizens either through expanding traditional Medicaid (as Kentucky has done) or implementing a private option (as Arkansas has done and proposed here in South Carolina) actually saves those states money in a number of ways, this new proposal for the feds to provide 100% funding for 3 years regardless of when a state joins the Medicaid expansion fold offers hope here in our state.