GOP lawmaker expresses doubt, withdraws support for Medicaid expansion bill

A Lowcountry lawmaker is scratching his name off a bipartisan bill that would accept federal money to set up health savings accounts for low-income residents in South Carolina.

A Lowcountry lawmaker is scratching his name off a bipartisan bill that would accept federal money to set up health savings accounts for low-income residents in South Carolina.

Rep. Bill Herbkersman, R-Bluffton, signed on to co-sponsor a House bill last week that would set up these accounts for about 340,000 South Carolinians using federal money intended to expand the Medicaid program. Herbkersman said he decided to add his name to the list of 74 other Democratic and Republican lawmakers under the false impression that state Health and Human Services Director Tony Keck supported the legislation.

“The bottom line is if Tony Keck does not support that bill, it’s probably for a good reason,” Herbkersman said.

After the bill was introduced Thursday, Keck said, “It’s basically just a way to get Obamacare without calling it Obamacare.”

Herbkersman revoked his support just hours after the bill was first introduced when Keck explained that it did not have the agency’s support.

“Tony is a fair guy. He has the staff and the time to drill down into any of these bills and see how it will impact that state and how it will impact each individual in the state,” he said.

On Friday, Herbkersman’s name was still officially attached to the “Truth in Health Financing and Responsible Consumer Health Care Act,” which would require special federal approval to implement. He said he may need to wait to officially remove it until the General Assembly reconvenes May 14.

Keck, who runs the state’s Medicaid agency, fielded several calls from lawmakers when the bill was first introduced Thursday.

“If it covers the same number of people and it has to operate under Medicaid laws and it doesn’t allow any of the features that actually help make providers and beneficiaries more accountable and it actually might cost more, it’s a little confusing to me why people think it’s such a great idea,” he said.

Under the federal Patient Protection and Affordable Care Act, states can accept federal money to expand the number of residents eligible for Medicaid. Keck has often repeated his position that the system is too expensive and isn’t making any one healthier, drawing a clear battle line between the Gov. Nikki Haley’s administration and the South Carolina Hospital Association, which supports expansion.

“When the professionalization of caring for the poor becomes a trillion dollar industry, you’ve got to wonder whose interests are being served,” Keck said. “We could have expanded (Medicaid) for the past 20 years and been handsomely matched from the federal government, but we didn’t until the gigantic hospitals realized that they were going to start getting cuts from other parts of the health care system.”

Rep. Kris Crawford, R-Florence, the bill’s main sponsor, said he never told Herbkersman that Keck supported the legislation. He also said he never consulted Keck when he drafted the legislation.

“The simple idea is that Mr. Keck is an agency head. As important as that is, he’s in the executive branch. This is a fundamental policy decision. I constantly talk about the fact that separation of government is important,” said Crawford, a physician.

“I think that South Carolina needs a more thoughtful position than ‘No, we can’t do that.’”

The General Assembly will break for the year June 6. Keck was hesitant to predict that the Medicaid expansion debate is winding down.

“I’m to the point where I’m done convincing and I’m just trying to get people aware of the facts as I see them,” he said. “I don’t think I’m going to have a magic chart that all of a sudden converts a bunch of people.’”

Reach Lauren Sausser at 937-5598.