Published on February 7, 2013

By Corey Hutchins, Free Times

Supporters of expanding Medicaid coverage in South Carolinalargely blame an anti-Obama partisan sentiment for opposition to the federal program. For them, the decision should be a no-brainer: Opting in to expansionwould give hundreds of thousands of South Carolinians health insurancecoverage, with the federal government picking up most of the tab.

Sue Berkowitz, director of the South Carolina Appleseed Legal Justice Center, says expanding Medicaid makes sense from a humanitarian standpointand an economic development standpoint.

As an employer for the Columbia-based nonprofit, Berkowitzprovides health insurance to her employees because it’s the right thing to do, she says. But another reason is that it’s important to have a healthy and educated workforce, and people can’t work if their health care needs aren’t being met.

“If we want to make sure we’re getting better health care coverage, [one way] is by making sure people have access,” she says. “And theycan’t access [it] if they’re not able to pay for it.”

In response to opponents of expansion who worry that some day the federal government won’t be able to pay the 90 percent it’s promised, Berkowitz says lawmakers could stipulate that if the feds can’t fund expansion in the future, then the state could suspend its participation.

Berkowitz expects a hard fight under the State House dome.

“But most good things are a tough fight for our state,” she says.

Bamberg County Democratic Rep. Bakari Sellers has introduceda bill in the House to accept the federal Medicaid expansion. He knows it will face opposition.

“South Carolina has this unique propensity to engage in whathas seemingly become a never-ending war against the federal government, notunderstanding that our tax dollars — instead of coming back home to South Carolina to help create healthier communities — are instead going to Georgia, Tennessee and North Carolina,” Sellers says. “I think hospital systems will suffer and some will have to shut down if in fact Medicaid is not expanded.”

Sellers says he watched a rural hospital in his home county close because of what he calls misguided policies. His bill, he says, would allow for $11 billion to come to the state over the next six or seven years.

The South Carolina Hospital Association strongly supports Medicaid expansion.

Under federal law, hospitals cannot turn patients away if they cannot pay for services. Hospital leaders agreed to reimbursement cuts under Obamacare so the savings could be invested in insuring more people.

In South Carolina, those cuts are $2.6 billion between 2014 and 2020, according to Thornton Kirby, president of the South Carolina HospitalAssociation. So, hospitals feel they are paying for Medicaid expansion regardless of whether the state in which they operate opts out. Those reimbursement cuts will lead to cost shifting, Kirby said in a video on the association’s website, and businesses will bear the brunt.

“So far, the political debate over Medicaid expansion hasbeen about the budget impact and the role of federal versus the stategovernment,” Kirby said. But, he said, the debate is really about people. If the state chooses to opt out, hundreds of thousands will be left uninsured, he said.

The Haley administration argues that hospitals are exaggerating the problem. It says it will make up the loss of reimbursement funds for 19 of the state’s poorest rural hospitals, and that the hospitals in wealthier areas of the state have hundreds of millions of dollars in assets and don’t need the reimbursement funds.

Frank Knapp, a local progressive talk show host who runs theSouth Carolina Small Business Chamber of Commerce, says the rhetoric of those who oppose expansion has scared some small business owners. Some people are simply paranoid about President Obama, Knapp says, and ascribe to Obama supernatural governmental powers he doesn’t have.

So, what does he tell his members about implementing Obamacare?

“We tell them the truth,” he says. “If you have less than 50 employees [online copy corrected], this does not impact you at all. You can offer insurance or not offer insurance; if you offer insurance and you have less than 25 employees you’re eligible for a tax credit, probably.”

An editorial in the Rock Hill Herald put it this way: “[N]ot expanding Medicaid coverage would simply preserve the status quo, in which uninsured residents either go to already overburdened free clinics or federal health centers, or use hospital emergency rooms for primary care.”

Original Article: http://www.free-times.com/archives/yes-to-medicaid-expansion

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