Solving one state problem addresses many others

By Frank Knapp Jr., The Greenville News

Published February 8, 2006

There is one issue the S.C. General Assembly could successfully address this year that would result in: attracting millions of out-of-state dollars into our economy, creating hundreds of high-paying jobs, increasing our per capita income, reducing the overhead costs for small businesses, preparing our children to learn, increasing the productivity of our work force, enabling small businesses to compete for skilled workers, making business recruitment easier and improving the overall health of our citizens.

Up to 850,000 South Carolinians have no health insurance. They are not covered by private insurance, Medicaid, Medicare, or any other public program.

Most of the uninsured are working, even business owners. But rising health insurance costs have driven about 60 percent of our small businesses out of the market due to affordability.

This crisis is getting worse every year. And every state is in the same situation. The difference is that while other states are taking actions to try to solve the problem of the working uninsured, we are not.

Hopefully, this is about to change.

A small coalition of organizations has offered realistic solutions to this crisis. The S.C. Small Business Chamber of Commerce, S.C. Appleseed Justice Center, S.C. Fair Share and the S.C. Association of Non-profit Organizations have taken steps to move the healthcare issue onto the state’s agenda.

These organizations believe that a combination of public/private hybrid solutions is needed to address both the cost of health care and health insurance.

Here is a summary of just two proposals.

The Small Business Chamber and the S.C. Primary Health Care Association have launched what appears to be a first-in-the-nation pilot program to make health care more affordable for small businesses without insurance. Affordability results form these community health centers being both nonprofits and qualified to draw down federal money to subsidize services to patients with incomes up to 200 percent of poverty.

Last September, Columbia-based Mid-Carolina Steel and recycling entered into a private sector agreement with two community health centers. Twenty-five employees and their families received primary and preventive health care from the health centers. The workers and family members had a $10 co-payment, and the employer paid the rest of the cost on a fee-for-service basis.

This pilot program has been a tremendous success for the employees, the health centers, and the the employer who can now afford to offer important health care to all his workers. The total cost to the business for the first three months– $980, demonstrating that employees did not abuse the healthcare series in spite of low out-of-pocket costs.

Efforts are under way to help other small businesses in the same way and to secure $5 million in state funding to enable community health centers to serve 12,000 to 15,000 more similarly uninsured across the state.

Like other states have already done, South Carolina has the opportunity to bring in millions of federal Medicaid dollars to provide health care to more children, their parents and adults without children with family incomes up to 200 percent of poverty. Working South Carolinians can receive assistance for their health insurance premiums individually or as part of their employers’ health insurance plans. With premium assistance from Medicaid for qualified workers, the employer can then afford to offer health-care benefits to all employees.

We can do this in South Carolina, but we will need a special Medicaid waiver. (This is not the waiver South Carolina is now seeking.) The state would provide funds for the program which the federal government would match about $2.5 Medicaid dollars for every state dollar. The potential benefits to the state are healthier children and working adults, stronger small businesses and a big boost for our economy.

In pursuing these viable solutions to our health-care crisis, first we must agree on which and how the programs should be implemented. Only then should we look a funding. The state is expecting an addition $815 million in new revenue this year. A modest increase in the cigarette tax (every penny brings in $3.45 million) is also an option since our neighboring states have much higher taxes compared to our 7 cents per pack.

The one option South Carolina cannot afford is allow its children, workers and small businesses to go without affordable health care and health insurance.


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