Checkup program to get new scrutiny

Christian Soura was named the new director of S.C. Department of Health and Human Services last year. His official confirmation is still pending state Senate approval. He will be responsible for South Carolina’s $7 billion Medicaid program.

The state government will not launch a large-scale campaign to promote a program that provides free primary care checkups to low- and middle-income South Carolinians.

The S.C. Department of Health and Human Services, which manages the new Healthy Connections Checkup initiative, had originally considered some sort of broad marketing plan to encourage people to sign up. Now, less than a year after the program made its debut, the agency’s new director wants to take a fresh look at “Checkup” and figure out “what we’re trying to accomplish with it,” a spokeswoman said.

“I’d like to have better answers about the long-term vision before we double-down on a marketing effort,” said Christian Soura, who was named the new Health and Human Services director in November. His official confirmation is pending state Senate approval.

Healthy Connections Checkup technically is a limited-benefit Medicaid plan, which offers patients one primary care appointment every two years, free birth control and a variety of preventive screenings. Anyone in the state whose income falls below 194 percent of the federal poverty level — or about $23,000 for a single adult — qualifies for a Checkup card.

But critics argue the coverage is inadequate and what many of these poor patients need is full Medicaid benefits. Conservative South Carolina leaders have refused to accept funds available through the Affordable Care Act to expand Medicaid eligibility in this state. With very few exceptions, childless adults in South Carolina are not eligible for full Medicaid benefits under current rules, no matter how poor they are.

“(Healthy Connections Checkup) provides no coverage if you’re ill,” said Shelli Quenga, programs director for the nonprofit Palmetto Project in Mount Pleasant. “That is part of the challenge.”

Even Soura acknowledged that the program was designed to identify potential health problems, but not actually treat them. That part is much more difficult — and expensive.

For example, a free screening may confirm that a patient has colon cancer or AIDS, but the Checkup card will not cover the cost of treating the disease.

“If you find something in the screenings, you’ve got to have somewhere to send folks. And in some places, we have a more developed answer to that than others,” he said. “It’s a big question for us on the program ownership side and I think for folks in the health care community, it’s a moral-ethical question, too.”

More than 100,000 South Carolinians are already enrolled in Healthy Connections Checkup, according to data provided by the Medicaid agency last year. Gov. Nikki Haley’s proposed 2016 fiscal year budget assumes enrollment eventually will reach 200,000 people.

That estimate, which was calculated before Soura was named the new director, may now change, he said.