SCOTUS | Health care ruling

What it means to SC’s poor

About 1 million could benefit

jholleman@thestate.comJune 29, 2012 

  • Medicaid eligible Who is covered now by Medicaid now: •  Pregnant women and children younger than age 6 with family incomes at or below 185 percent of federal poverty level (about $42,000 for a family of four) •  Children ages 6-18 with family incomes at or below 200 percent of federal poverty level ($46,100 for a family of four) •  People who qualify for Supplemental Security Income benefits based on low income and disability status Who would be added under ACA expansion provisions starting in 2014: •  Nearly all people younger than 65 with household incomes at or below 133 percent of federal poverty level ($14,856 for individuals, $30,657 for a family of four)

The lines started forming outside Carolina Coliseum more than 12 hours before S.C. Mission 2011 opened its doors last August.

People without health insurance were willing to put up with a hot, sweaty night on the concrete to get an aching tooth pulled or a chronic cough diagnosed. In two days, volunteer health care workers treated more than 2,000 patients. Probably that many more gave up after waiting for hours in the long limes.

S.C. Mission 2011 shined a light on the estimated 1 million people in the state without health insurance. The Affordable Care Act was designed to get those people into the health care system by 2014, either by expanding the eligibility rules for Medicaid or setting up affordable health insurance exchanges.

The U.S. Supreme Court’s decision Thursday that the 2010 act passes constitutional muster means many of those uninsured will have access to health care.

“In 2010, we took a significant step forward to protect health care consumers in America and grant them greater rights of health care coverage and services,” said Sue Berkowitz, director of the S.C. Appleseed Legal Justice Center. “I am pleased as an advocate and a mother of two young adults that we can move forward with the implementation of this very important law that will ensure that all in our country have access to quality affordable health care.”

Those benefiting most from the changes in 2014 will be the adult working poor. Children 18 and younger in families of four making up to about $40,000 already were covered by Medicaid. Those older than 65 have Medicare.

But the working poor ages 19-65 mostly had to fend for themselves. If the state doesn’t opt out of the Affordable Care Act expansion, individual adults making less than about $15,000 and adults in families making less than about $31,000 will be eligible for Medicaid. The state Health and Human Services agency estimates nearly 500,000 more people will qualify.

Advocates for the poor, and for health care in general, are excited about the impact of getting more people into doctors’ offices. The S.C. Hospital Association, while concerned about some of the details of the Affordable Care Act, backed it because it would help cover the uninsured.

“How can South Carolina not benefit from our population having improved access to care – care that includes preventive services and chronic-disease management?” said Columbia health care economist Lynn Bailey. “Healthy people don’t happen by luck, at least not in South Carolina.”

Haley, Keck on the Supreme Court healthcare ruling

SC Gov. Nikki Haley and Health and Human Services director Tony Keck remark on the US Supreme Court's June 28, 2012, ruling upholding most aspects of the Affordable Care Act. Video by R. Darren Price.

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