More than 200,000 poor, working adults will remain uninsured in South Carolina if conservative state leaders don't change their position on Medicaid expansion under Obamacare, a panel of health care experts said Wednesday.

The decision may also affect hospitals' ability to borrow money for new projects and could increase the cost of private health insurance premiums by $120 per person, said Schipp Ames, manager of advocacy communications for the South Carolina Hospital Association.

"We're drawing down federal dollars for roads, but, for some reason, when it's health care, it's a different issue," he said.

Ames was one of three Medicaid expansion advocates who spoke on the panel at Roper Hospital on Wednesday. A representative from Gov. Nikki Haley's administration was invited to participate but declined, an organizer said. Haley has been a vocal opponent of the Affordable Care Act.

South Carolina is one of about half of all states that has decided to turn down federal dollars to expand Medicaid eligibility starting this year.

Money for the expansion was made available under the federal health care law, but the U.S. Supreme Court ruled in 2012 that individual states cannot be compelled to expand their programs.

States that choose to participate will receive 100 percent of the money to cover Medicaid expansion costs through 2017. After that, the state governments must chip in a small percentage - eventually 10 percent by 2020.

Ames said South Carolina is turning down $11 billion in federal dollars through 2020 by declining to participate.

But, he conceded the prospect that the Legislature or Haley will change their minds is slim.

"We're not getting any closer to accepting Medicaid expansion, from my view," he said.

Robert Greenwald, a Harvard Law School professor who also participated in the discussion, said Haley has boxed herself into a political position that she can't back out of.

"We've got to figure out a way to help her out of the box," Greenwald said. "Political whims change quickly. We just have to stay the course."

About 40 people attended the panel discussion. Many of them were hospital employees. Organizers encouraged the audience to contact their legislators about the issue.

Bill Settlemyer, founder of the Charleston Regional Business Journal, also participated in the discussion.

Reach Lauren Sausser at 937-5598.