South Carolina health care experts react to House vote on Obamacare replacement bill

Charleston Post and Courier
May 4, 2017

By Lauren Sausser and Mary Katherine Wildeman

Health care experts in South Carolina quickly reacted to a House vote Thursday to replace the Affordable Care Act.

Shelli Quenga, director of programs for the Palmetto Project, took issue with the fact that there is not yet a Congressional Budget Office Score on the bill projecting costs and impact.

“We’re very disappointed to know that our representatives would choose to put the health of South Carolinians in jeopardy without having figures to know how much it will cost and how many people it will affect.”

She said previous CBO projections on an earlier version of the bill looked dim for the state. Senate members should take the time to wait for a CBO score and debate the bill’s minutiae the way it was done when the Affordable Care Act was passed, she said.

“Perhaps the Senate will be able to do what the House was not able to,” Quenga said.

Ray Farmer, director of the S.C. Department of Insurance and a member of Gov. Henry McMaster’s Cabinet, said it was “way too early” to speculate how the House measure might impact the insurance industry in this state.

“We look forward to reviewing the details of the bill and then we’ll look forward to seeing how the Senate changes that bill or introduces a bill of its own,” Farmer said.

Frank Knapp, president and CEO of the state’s Small Business Chamber of Commerce, was quick to criticize the bill, specifically a provision that strips tax credits from small businesses to help them offer insurance to their employees. “They’re yanking that away from us,” Knapp said.

He said the bill shifts responsibility to state legislatures, adding that some of the decisions state lawmakers may have to make, such as whether insurers must cover pre-existing conditions, will not be easy.

“I think if anyone is a loser here, it is the legislatures of the red states that would have to make that hard and unpopular decision,” Knapp said.

Christian Soura, vice president of policy and finance at the S.C. Hospital Association and previously the South Carolina Medicaid director, said it’s difficult to gauge the impact of the plan without an updated analysis from the Congressional Budget Office.

“It’s hard to know since they voted on the bill without having a CBO score,” Soura said. “We don’t have a clear picture of the impact.”

The Congressional Budget Office scored an earlier version of the bill and Soura said that estimate indicated more than 200,000 South Carolinians could lose coverage.

The bill also would reduce Medicaid spending, which could impact health care services to the elderly, the disabled and children in South Carolina.

“That’s the biggest component of the Medicaid population,” he said.

But the legislation will likely change in the Senate, he said. “Everybody has been building and waiting for this day, but really, it’s just the beginning.”

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