Medicaid Enterprise Systems Conference wraps in North Charleston

John Supra, deputy director of the S.C. Department of Health and Human Services, which administers the Medicaid program in South Carolina. .Leroy Burnell/ 9/9/2013

Politicians have been debating the value of Medicaid for decades.

Why won’t South Carolina expand it? Who deserves to qualify for it? Should poverty entitle the poorest among us to government-subsidized health insurance?

But the 2013 Medicaid Enterprise Systems Conference, which ended Thursday in North Charleston, was decidedly apolitical.

Over five days, about 1,200 health care experts from around the country discussed how Medicaid in each state can be improved and how technology can facilitate those improvements.

Sessions this week included “Medicaid modernization,” “Creative strategies for meeting ACA (Affordable Care Act) deadlines,” and “The value of collaboration.” These were workshops designed for Medicaid wonks.

“We can sit at the table and disagree about the policies, but at the end of the day we have to deliver the programs,” said John Supra, deputy director of the S.C. Department of Health and Human Services, which administers the Medicaid program in South Carolina.

Unlike with Medicare, each state administers its own Medicaid program, which is designed to provide health insurance to low-income residents, because each state is required to help pay for it and, within parameters, can customize some of the rules.

For example, childless adults can’t get a Medicaid card in South Carolina, regardless of how poor they are, unless they have a qualifying medical condition like pregnancy or blindness. Some states allow healthy low-income adults without children to qualify.

South Carolina leaders believe giving someone health insurance doesn’t necessarily make them healthier, Supra said during the conference’s closing session Thursday.

“The health and wellbeing of individuals, communities, the population that we serve, to make them truly healthy, we need to be focused on a lot more than just the health services — the impact of education, the impact of employment, of food security, of transportation,” Supra said. “In South Carolina, we actually know that Medicaid alone isn’t enough.”

Randy Canoy, a project manager at the Oregon Health Authority, attended the conference in North Charleston this week. Making Medicaid more efficient is a huge challenge, he said.

“What we get from these sessions is more of the visionary piece,” Canoy said. “For me, coming from Oregon, that’s where the value is.”

Unlike South Carolina, Oregon has decided to expand its Medicaid program to any resident who earns up to 138 percent of the federal poverty level, which equals about $15,400 a year for a single adult. The federal government will help Oregon, and any other state that chooses to expand Medicaid, pay for the expansion starting next year through the federal Affordable Care Act, commonly called “Obamacare.”

South Carolina, led by a conservative Legislature, will not expand Medicaid because the U.S. Supreme Court ruled last year that the expansion is optional.

Gov. Nikki Haley, who spoke at the conference on Monday before attending an international car show in Germany, opposes expansion partly because she said Medicaid already costs too much.

“We all recognize that half the states represented in this hall are expanding Medicaid and half are not,” Haley said Monday. “What I did not see on your agenda for the next few days, however, was lots of hand-wringing and debate about these differences. What I did see was a lot of hard work and attention paid to implementing better systems that produce better health at lower cost, regardless of your state’s decisions. We have to keep this as our focus.”

Reach Lauren Sausser at 937-5598.