Senators scrap plan to insure 194,000 working poor in S.C.

Senate budget writers scuttled a proposal Thursday to create a program that would have used federal and state dollars to pay for private health insurance for almost 200,000 South Carolinians.

But the proposal will re-emerge within two weeks as standalone legislation, said state Sen. Joel Lourie, D-Richland.

“These are our neighbors,” said Lourie. “These are our friends. These are hardworking, taxpaying South Carolinians.”

Lourie withdrew his amendment to create the program after it became clear senators did not support debating the proposal as part of the state budget.

Roughly 194,000 South Carolinians, most members of the working poor, could have been insured by the program. Most earn too much to be eligible for Medicaid but make to little to qualify for federal subsidies for health insurance under the Affordable Care Act. They do not make enough to afford their own coverage.

But other senators, including powerful Senate leader and Senate Finance Committee chairman Hugh Leatherman, R-Florence, opposed the way Lourie suggested creating the program.

Leatherman said a far-reaching proposal of the magnitude that Lourie proposed should not be made law as part of the budget. Instead, the proposal should go through the normal vetting process used for standalone legislation, going from introduction to subcommittee to committee to the Senate floor.

Lourie said senators will file legislation that mirrors the budget amendment within the next two weeks.

Previous attempts to expand the federal-state Medicaid insurance program for the poor in South Carolina as part of the federal Affordable Care Act, also known as Obamacare, also have failed.

Republican Gov. Nikki Haley, who opposes expanding Medicaid, said earlier this week that she would fight Lourie’s proposal as well.

But Leatherman said the threat of a veto by Haley did not carry as much weight after the House approved a roads plan Wednesday that the Republican governor had threatened to veto. That plan passed the House 87-20, a large enough margin in the GOP-dominated House to survive a veto.

“I’ve never been afraid of a veto,” Leatherman said after the meeting, adding the House vote sent a “tremendous message.”

Lourie’s proposal had bipartisan support.

Republican state Sens. Paul Campbell of Berkeley and Ray Cleary of Georgetown sponsored the proposal, along with Democratic state Sen. John Matthews of Orangeburg.

A half-dozen members of the 23-member Senate Finance Committee spoke out in favor of the proposal Thursday. Some cited studies saying expanding Medicaid would be a multibillion-dollar boon to the state’s economy, adding the state is willing to spend hundreds of millions to attract economic-development projects.

Opponents sat silent, in part because it was clear the proposal would not advance in the budget.

Lourie told the committee the proposal is “not about whether you are for or against Obamacare.”

Instead, he said, the proposal would create a public-private partnership to close the healthcare coverage gap between the working poor and other South Carolinians.

Lourie said it is much less expensive for an insured South Carolinian to go to the doctor for preventive care than for an uninsured resident to go to the emergency room, leaving taxpayers to pick up the tab.

Campbell, a retired business executive, said he is not for expanding Medicaid, but looks at the proposal from a business perspective. There has to be a more cost-effective way to pay for health care for poor South Carolinians than the current system, he added.

The proposal would have followed a framework being used in GOP-controlled Arkansas.

In South Carolina now, adults who are not disabled and earn $15,000 or less are ineligible for Medicaid, with a few exceptions. Parents of young children are eligible for Medicaid if their income is about $7,000 or less, and pregnant women are eligible if their income is about $23,000 or less.

Twenty-eight states and the District of Columbia have expanded their Medicaid programs in some form since the passage of the Affordable Care Act.

The U.S. Supreme Court is set to rule this summer on whether the operation of the federal insurance marketplace, part of the Affordable Care Act, is illegal in many states.

This story was originally published April 16, 2015 at 10:18 PM with the headline "Senators scrap plan to insure 194,000 working poor in S.C.."