Creative ideas, planning needed for health care

By Frank Knapp Jr., The Greenville News

February 15, 2008

Consensus is building among healthcare stakeholders in South Carolina on how to use new revenue from an increase in the cigarette tax. These funds should be used for health care in general and specifically to help those who cannot afford health insurance due to low income or pre-existing conditions.

For several years, The SC Small Business Chamber of Commerce, SC Appleseed Legal Justice Center, and SC Fair Share have promoted legislation that would provide premium assistance to small businesses for health insurance premiums of employees with family incomes under 200 percent of the Federal Poverty Level ($41,300 for a family of four). WE believed that by reducing the cost of health insurance for the employer and these qualifying employees, the employer would be better able to afford to offer a group health plan to all employees.

Last month this concept was expanded by the Covering Carolina Collaborative representing doctors, hospitals, insurance companies and large businesses. The Collaborative proposed that cigarette tax revenues be used to subsidize the health insurance for low-income, uninsured South Carolinians either as individuals or within a small group plan. Tax credits that would be refundable and advance able would be available for individuals with family incomes up to 250 percent of the Federal Poverty Level ($51,625 for a family of four) or to their employers to be used for the purchase of approved health care insurance plans.

All parties also agree that the state should use cigarette tax or other revenue to expand Medicaid coverage to parents below the Federal Poverty Level ($20,650 for a family of four) and expand to the State Children’s Health Insurance Program (SCHIP), with state or state/federal funds, to cover children in families of up to 250 percent of the Federal Poverty Level.

This consensus among the varied groups may dramatically increase the chances of passage of a cigarette tax this year. Using the new funds to help small businesses and qualifying individuals better afford or have access to health insurance will be a powerful incentive for legislation success.

However, effective utilization of a cigarette tax is only a part of the real health care reform that we need. Systemic reform will require more discussion about how to address the majority of uninsured who are not low-income, how to reduce costs within the system and how to make health insurance affordable for those with pre-existing conditions. Plus, we need to set healthcare go gals for South Carolina.

Last month the Colorado Blue Ribbon Commission for Health Care Reform released just such a comprehensive report for that state. Colorado’s effort can be used as a model for such a commission here. This effort will require updated statewide health information collected for its use.

As we begin the process of setting health-care goals, The SC Small Business Chamber of Commerce believes that we need bold ideas in line with our common principles.

One of these shared principles is that our children are our most precious responsibility. It is this belief that causes us to support providing Medicaid to low-income children. But we draw artificial income lines for our responsibility when we should be agreeing that all South Carolina’s children should have guaranteed access to quality health care regardless of a family’s ability to pay and regardless of the health status of the child or other family members. The same principle of universal health care for our seniors should be extended to all our children.

In addition to the obvious health benefits, there are numerous economic benefits:

1. Low-income parents will no longer have their upward mobility blocked by concerns of losing health care for children if they exceed artificial income levels.

2. Parents with health children make better, more productive employees.

3. Employees will largely stop job-shopping to find health insurance benefits and will be more willing to work in small businesses.

4. Entrepreneurship will be advanced with the elimination of income concerns to pay for health insurance for children.

5. All families will be financially stronger and have more buying power by reducing the burden of paying higher insurance premiums for total family health coverage.

6. Small businesses will be more competitive in attracting skilled workers against big businesses that can better afford to offer complete family health coverage

7. Such a program will be a significant economic development tool for our efforts to attract business of all sizes to the state

Designing a program of guaranteed coverage for all South Carolina children can be accomplished as some other states have already done. Private health insurance companies could participate in providing coverage to children in families above Medicaid limits.

Let’s build on the consensus we are developing with aggressive new planning and bold ideas.

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