House Reconciliation Bill and its impact on Medicaid

Other amendments in the House Reconciliation bill

The Medicaid expansion match rate was preserved at 90%, although the bonus for the 10 non-expansion states was eliminated. A Cover SC brief on the true cost of expansion explains why expansion would have a positive outcome for the State.  Additionally, work requirements for the expansion population are estimated to result in a major loss of coverage in the 40 expansion states, mainly due to burdensome documentation requirements and would reduce some of the positive economic impact of expansion that Cover SC documented.

Feedback to Governor McMaster’s Work Requirement Waiver

Cover SC thanked the Governor for any consideration of expanding Medicaid, however modest the expansion of eligibility.   Cover SC, however,  recommended major changes to the work requirements including: exemptions for dependent care and illness/disability, targeting only the very small group not exempt who don't work at all, and the provision of a case management/service support program for those individuals to identify barriers to working and provide other supports. 

Public Health in South Carolina

The opposition of the Freedom Caucus to vaccine mandates during COVID jettisoned the appointment of Dr. Edward Simmer to head the new Department of Public Health, (formerly part of DHEC).  Simmer had been confirmed by the Senate prior to COVID and lead the DHEC throughout the pandemic.

Public health is frequently funded only with federal dollars and the new budget slashing by the President and Congress threatens programs offered through the SC Department of Public Health.  According to the Regional Director of the American Cancer Society – Cancer Action Network, the Office of Tobacco Prevention at DPH has already been eliminated.  Colorectal Screening and Breast Cancer Prevention initiatives only have one more year of funding before they are eliminated, as well, unless the state steps up to fund them.