S.C. lawmakers assail health care plan

rburris@thestate.comDecember 22, 2009 

  • S.C. impact

    Exact figures on how the health care overhaul will affect South Carolina are unknown, even after the U.S. Senate paved the way for a bill to pass this week. But Gov. Mark Sanford said the state has projected how the bill in the U.S. Senate and a similar one in the U.S. House would impact Medicaid and taxes.

    MEDICAID EXPLOSION | The state estimates Medicaid would grow by 543,000, or increase the health insurance program for the poor by roughly 70 percent by 2019. Sanford estimates Medicaid eventually could insure 1.3 million South Carolinians, or 30 percent of the state. Nearly one third of South Carolinians lack health insurance, something the Medicaid expansion would help remedy.

    INCREASED COST | Sanford estimates the expanded Medicaid rolls would cost South Carolina between $687 million and $1.17 billion by 2019. Sanford estimates the state would have to raise taxes to pay for this. Others say no one can say with any certainty how lawmakers will build the 2019 budget. But on the federal level, families earning more than $250,000 would pay more in taxes.

    SMALL BIZ HELP | Small businesses, which employ most South Carolinians and struggle to pay health care premiums, would get relief with more workers qualifying for government care. Under the Senate plan, however, companies with more than 50 employees would pay a fee for workers who rely on government subsidies to buy coverage.

    PATIENT PROTECTIONS | The bill will prohibit insurance companies from dropping patients and denying coverage for pre-existing conditions. The Senate bill, however, has no public option, or a government-run health plan competing with private insurers.

    SOURCE: State of South Carolina

With the clock ticking toward a Christmas Eve Senate vote on health care reform, South Carolina Republicans lashed out Monday at the proposed legislation, and also took swipes at Democrats for the tactics used in moving the bill forward.

South Carolina would have 481,000 uninsured residents covered under the plan, according to one estimate.

"This is Washington politics at its worst, and I urge the American people to help scrap this backroom bill," said U.S. Rep. Joe Wilson, R-S.C.

U.S. Sen. Lindsey Graham asked South Carolina's attorney general to look into a Medicaid deal for Nebraska struck to secure the 60th vote required to advance the bill - that of Sen. Ben Nelson, D-Neb.

Even before the pending Senate bill was fully unveiled, Republican Gov. Mark Sanford warned federal lawmakers that Congress' pending reform initiatives would hurt the state, hamstringing private insurers and swelling entitlement spending in South Carolina by as much as $1.3 billion.

"The bills being debated will also add a new group of people eligible for Medicaid - adults with no children - to the state's Medicaid rolls," Sanford said in a letter to the state's U.S. senators.

But a Washington, D.C.-based advocacy organization for health care consumers says nearly a half-million uninsured South Carolinians will gain coverage under the newly minted Senate proposal alone.

And U.S. Rep. Jim Clyburn, D-S.C., one of the highest-ranking members in House, said all the criticism is itself rushed.

"I don't know what is in the Senate version, and no one knows what the blended version will yield," Clyburn said Monday evening. "It is a bit premature to say how South Carolina will be affected."

With the Senate seemingly poised to approve a final version of its bill Christmas Eve, who is right may be less the question than who will prevail in the continuing, strident health care debate of 2009.

Wilson, in a statement issued Monday after the crucial 1 a.m. vote was taken to clear the bill for final considerations before a full Senate vote, called for a vocal response to Senate Democrats' plans to pass the reform measure.

"'Tis the season for the American people to make their voices heard," said Wilson, who hosted town hall meetings this summer that gave outspoken opponents a forum.

Families USA says 481,000 people in the Palmetto State would gain coverage in 10 years under the Senate version of health care reform, while without it, 124,000 people in the state would lose their coverage by 2019.

"The consequences of inaction are very severe for people in South Carolina," said Ron Pollack, Families USA executive director. "The Senate has an opportunity to provide peace of mind to families by providing and extending health coverage to virtually everyone in South Carolina."

Sanford put his health care reform concerns in a Dec. 10 letter to Seneca Republican Graham, saying the combined House and Senate bills would put 30 percent of the state's population on Medicaid by 2019.

"The House bill not only adds this new category of eligibles (childless adults)," Sanford said, "but would also increase current eligibles in (the aged, blind and disabled, specified low income Medicare beneficiaries, and low income families)."

Under House legislation, most individuals at or below 150 percent of the federal poverty level (for families of four, $22,050 in total household income) and under age 65, including children, pregnant women, parents, childless adults, and individuals with disabilities would become eligible for Medicaid in 2013.

The federal government would foot those bills without state help for two years, after which states would pay 9 percent of the added costs.

Whatever passes the Senate will have to be merged with the existing House bill, then approved by both the Senate and House before being signed into law by President Barack Obama.

One of the biggest private sector influences from the reforms, Sanford stated, is that insurance premiums would rise by 18 percent over the 10 years leading into 2019.

"Proposals to eliminate pre-existing condition exclusions and to guarantee policy issuance will have a crippling effect on our health insurance industry," Sanford said.

Taxes would rise, too, he said, in part as a result of the expiration of former President Bush's tax cuts, and due to increases in income taxes on top earners.

Graham said he wants S.C. Attorney General Henry McMaster to review how Nebraska Sen. Ben Nelson was able to spare his state higher Medicaid costs as the Democrat held out for perks for his state in the mammoth Senate bill.

McMaster's spokesman said the attorney general will discuss the issue with Graham.

Nelson's spokesman didn't immediately respond to questions Monday. But Democrats back home praised his efforts.

The Associated Press contributed. Reach Burris at (803) 771-8398.

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