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Signing up for Medicaid more difficult

  • Updated

COLUMBIA -- Tens of thousands of South Carolinians likely are eligible for government-run health care but aren't signed up because bureaucratic red tape creates obstacles, advocates said Monday.

Sue Berkowitz, director of Appleseed Legal Justice Center, and John Ruoff, program director for South Carolina Fair Share, said Medicaid enrollment isn't keeping pace with the need, despite the seemingly rapid increase during the state's deep and prolonged economic downturn.

Advocates are working to identify how great the need is, but an exact number isn't clear. More than 750,000 people are estimated to be without health insurance in the state, although not all of them are eligible for Medicaid.

A report Sunday by The Post and Courier revealed that as many as 112 people a day sign up for Medicaid in South Carolina. More than 90,000 have enrolled since the recession officially hit in December 2007.

The state's Medicaid agency, the Department of Health and Human Services, should share data with other state agencies that administer social welfare programs, such as the Department of Social Services, to make it easier on the people who need help to get it, Berkowitz said. That's one example of what the Health and Human Services Department can do to be more user-friendly, she said.

But that's an expensive proposition, said Jeff Stensland, director of communications for the Health and Human Services Department.

Linking personal information between state agencies to help streamline the process of certifying a person's eligibility would require an overhaul of the records system at the agency.

Such an undertaking would take a funding commitment from the Legislature, and the state is barely able to provide core government services at this time.

About 800,000 individuals are enrolled in Medicaid, approximately the level it was in 2006, before the state started requiring people on the rolls to prove their citizenship and certify each year that their household income meets qualification standards, Berkowitz said.

If the state cross-shared data among government agencies, it would help prevent eligible people from being kicked off the rolls for failing to file adequate paperwork, she said.

Ruoff said the unfilled needs can be partially gauged by comparing the rate of growth for people on food stamps with the rate of growth for those on Medicaid.

Between February 2008 and March 2010, enrollment in Medicaid grew by 11 percent compared with 37 percent for food stamps, known now as Supplemental Nutrition Assistance Program, or SNAP.

More people can qualify for food stamps than Medicaid. Still, Ruoff said the rates of people on Medicaid and food stamps should grow more proportionately.

Stensland said a comparison between food stamps and Medicaid enrollment is not appropriate because of the two different sets of eligibility standards.

"We have not altered our enrollment policies in any way that would make it more burdensome for eligible residents to enroll in Medicaid," Stensland said in an e-mail. "In fact, states are now prevented by federal law from doing that. ... We do still need to ensure that each individual who applies for Medicaid is actually eligible for the program, and we will not alter our processes in any way that would harm the integrity of the program."

Reach Yvonne Wenger at 803-926-7855 or

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