South Carolina should accept an estimated $2 billion in money under the federal health care act to expand Medicaid to hundreds of thousands of additional working poor in the state, State Sen. Vincent Sheheen said Thursday in Charleston.
“I call on Gov. (Nikki) Haley and every Democrat and every Republican to heed the example of other states and provide leadership that will mean more tax dollars in South Carolina that belong to South Carolinians,” the Camden Democrat said.
Sheheen, who held his news conference on the horseshoe of the Medical University of South Carolina, is mentioned as a candidate for governor in a rematch next year against Haley, who defeated him in 2010.
“This announcement does not mean I’m running for governor. This announcement means I’m trying to advocate for the people of South Carolina,” he said.
Sheheen has said he has been weighing what effect the Medicaid expansion might have. He said the state should go ahead and accept the federal money for the first three years. Then, he said, the state should review whether it makes financial sense to continue.
Under the health care act, Washington pays for the first three years of the Medicaid expansion. After that, the state picks up 10 percent of the cost.
Haley is adamantly opposed, saying the state can’t afford the eventual costs.
According to the state’s actuaries, the expansion would cost the state between $1 billion and $2.4 billion extra through 2020. The next seven years with the full 10 percent match would be more expensive.
“After years of ducking and dodging, it’s at least good that Vince has finally taken a position. Unfortunately, his position in support of Obamacare would bust the South Carolina budget and do nothing to reduce health care costs,” said Haley spokesman Rob Godfrey.
But Sheheen said taking the money for three years makes sense.
“If we reject it during these years it will cost us billions of our taxpayer dollars that will go to other states,” Sheheen said. “So if you want save South Carolina taxpayer dollars, how can you turn away billions of dollars and call yourself responsible?”
He said several other states with Republican governors who fought the health care law, including Florida, have come to the same conclusion.
Republican U.S. Sen. Lindsey Graham weighed in after Sheheen’s announcement and said “Medicaid expansion would be disastrous for South Carolina. It is terrible public policy that we can’t afford and won’t make our people healthier.”
Republicans in the state House are also opposed, saying the state can’t simply add people to an already bloated, inefficient Medicaid system. They also argue that it would be impossible politically to simply reject the federal money after three years and toss hundreds of thousands of people off the program.
But Sheheen said some Republicans are telling him they favor the Medicaid expansion although they worry about saying so publicly.
Sheheen said he would work in the coming weeks to forge “a compromise that puts South Carolina ahead of partisan ideologies and keeps South Carolina taxpayers’ dollars here in South Carolina.”
The expansion would increase Medicaid eligibility to all adults — including those without children — who earn less than 138 percent of federal poverty guidelines. That translates to income limits of roughly $15,400 for an individual and $30,650 for a family of four.
Even without expanding eligibility, the state’s Medicaid agency says the law is expected to add 170,000 already-eligible people to Medicaid rolls as people learn of the option, enroll to avoid fines, lose insurance through their jobs or can no longer afford it. Their coverage will be paid according to the regular match rate of 30 percent.
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