Advocacy groups to start pressuring Haley to accept expansion of Medicaid rolls

jholleman@thestate.comDecember 10, 2012 

— Health care advocates at events in Columbia on Tuesday will begin putting public pressure on state legislators to buck Gov. Nikki Haley and accept the Medicaid expansion under the Affordable Care Act.

The advocacy groups will stage a news conference at 10 a.m. the State House, a coalition-building and training meeting from noon-3 p.m. at the Clarion Hotel Downtown and a public forum at 6 p.m. at the USC School of Law. Robert Greenwald, director of the Harvard Center for Health Law and Policy Innovation, will be the featured speaker at the training session.

Bambi Gaddist, executive director of the S.C. HIV/AIDS Council, helped put together the events designed to spread the word about what the ACA means to state residents. She also hopes to turn up the volume in the discussion about Medicaid expansion before the state Legislature convenes in January.

“South Carolina leadership must take steps to educate citizens about the new federal law because it will change how we gain access to health care for years to come,” Gaddist said. “This community forum is needed to make sure South Carolinians get information first hand from the leading health authorities in the state and nation.

“Simply stated, no South Carolinan can afford to just stay home. Whether young or old, insured or uninsured, everyone should come out and learn how health care reform will impact them and their families.”

Haley and Tony Keck, her appointed director of the S.C. Department of Health and Human Services, have expressed their opinions often since the U.S. Supreme Court last summer gave states the option to decline the expansion of Medicaid rolls. They see Medicaid as a broken program that stifles innovation, discourages personal responsibility and encourages fraud.

Instead of expanding the federal one-size-fits-all-states program, they want the feds to give South Carolina freedom to make its own changes. Keck suggests the state’s health care costs can be cut with a three-pronged effort aimed at payment reform, better coordination of services and targeting of hot spots of poor health. Keck plans to participate in Tuesday’s public forum.

Under the Affordable Care Act, states have the option of expanding their Medicaid programs to cover all adults earning less than 138 percent of the federal poverty level, which translates to about $15,000 for an individual. Keck touts estimates that Medicaid expansion would add about 513,000 people and increase South Carolina’s share of the program’s cost by $1.7 billion by 2020.

Some advocates of the expansion at Tuesday’s events use a different number, citing studies that indicate about 329,000 people in South Carolina who earn less than $15,000 do not have health insurance.

The costs to the state are small compared to the amount of federal dollars that would come into the state through Medicaid expansion. The federal government will cover 100 percent of the costs in 2014-2016, with the states picking up a gradually increasing portion through 2020. At that point, the feds will be paying 90 percent and the states 10 percent.

If South Carolina turns down the expansion, it will be leaving $3 billion of federal money on the table, advocates say.

Among the pro-expansion advocacy groups participating in the events Tuesday are AARP South Carolina, the American Heart Association, Columbia Urban League, the March of Dimes, the S.C. Cancer Alliance and United Way Association of South Carolina.

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