The Post and Courier’s March 17 editorial, “Rejecting Medicaid folly,” deserves a response.
Instead of accepting fully funded federal dollars to insure 350,000 low-income South Carolina families for the next three years at no cost to the state, Gov. Nikki Haley and her Health and Human Services director Tony Keck propose spending $75 million annually in state dollars. Not only would their plan cost more, but it would reach only one-fifth of those who would be added by adopting the expansion of Medicaid.
After the program’s third year, during which the governor’s more costly plan would expend $225 million in state funds, nine out of every 10 dollars funding the proposed Medicaid expansion would still come from federal sources. South Carolina taxpayers, in effect, would be getting a refund from Washington, instead of spending more on the governor’s plan and also giving up to other states billions of dollars meant for South Carolina.
The editorial said the projection of additional annual cost for S.C. taxpayers by 2020 ranges from $613 million to $1.9 billion, but didn’t identify the sources of such costs.
Accepting the federal money will lead to multiple positive returns according to financial analysts at the University of South Carolina’s Darla Moore School of Business. They report that costs to the state will eventually decline as the population’s health improves due to greater access to insurance and preventive medical care.
Additionally, more insured patients will mean more reimbursement, helping to make up for the $2.7 billion our hospitals are losing between 2014 and 2020. That foregone money, known as disproportionate share, will help the federal government pay for Medicaid expansion whether South Carolina is on board or not.
Of course, the $4 billion in annual wages from the state’s healthcare workers would continue to flow into our communities, as widespread layoffs would be avoided.
A second level of positives relates to the governor’s emphasis on creating jobs. According to the USC report, expanding Medicaid is the way to do that, too.
Analysts project that the $11.2 billion in federal money gushing into South Carolina from Medicaid expansion would result in 44,000 new jobs over the next seven years. New jobs mean increased revenue from taxes. New jobs also mean more people with more money to spend, resulting in increased tax revenue and economic growth.
Ultimately, however, there is the element of social justice. It is simply the moral choice to see that those without medical insurance receive it until they can purchase it on their own.
Even this newspaper’s own highly regarded writer and editor, Doug Pardue, in his remarkable series, “Forgotten South Carolina,” promoted the advantages of Medicaid expansion after he detailed the state’s population health challenges. Pardue wrote, “Solution: Take the federal government up on its offer to extend Medicaid to the uninsured.”
This is our chance to build a better workforce by breaking the cycle of poor health and poverty for thousands in our state, as healthier people are more productive.
This is our chance to keep our hospitals healthy, as they’ll have more insured patients to make up for simultaneously losing billions in other funding. And this is our chance to simply do the right thing for our neighbors.
Expanding Medicaid is the right thing to do for job creation; for our state’s economy; for our healthcare providers who now treat uninsured and uncompensated patients; but most importantly it’s a right thing to do for the citizens of South Carolina who wake up every day without healthcare insurance coverage, something that no citizen in a country great as ours should ever have to do.
John M. Jordan Jr. is chief executive officer of the Medical Society of South Carolina.