Could Medicaid expansion soon be on the table in South Carolina?

COLUMBIA, S.C. (WCSC) – Medicaid expansion has long been something of a third rail at the South Carolina State House since it became an option about a decade ago.

Since then, 40 states have opted to expand eligibility to the government-funded program that provides health coverage to lower-income Americans, but not South Carolina.

One Republican lawmaker believes it is now time to at least have a conversation about it, as part of larger discussions into reforming the healthcare market in South Carolina.

“If we don’t do something, we’re lurching toward a single-payer system,” Sen. Tom Davis, R-Beaufort, said. “We’re lurching toward a system where people throw their hands up in the air and say, ‘This is too darn complicated. We’re going to turn everything over to the government and have them on a top-down basis manage everything.’ That would be a disaster.”

Davis wants to form a new committee that would study the issue in the coming months to determine what changes to the healthcare market would benefit South Carolinians.

The committee would be established through a provision in the proposed state budget, which will be finalized by lawmakers in the coming weeks.

Davis is optimistic it will come to fruition.

“This particular study committee looks at two sides of the healthcare market equation: the supply side, which is expanding the number of providers and what they’re able to do, and the demand side, which is empowering patients,” he said.

More than a dozen potential reforms could be on the table for its recommendation, including facilitating the expansion of telemedicine, ensuring cost transparency, and eliminating requirements for collaboration between different health professions.

Also among them would be making South Carolina the 41st state to expand Medicaid eligibility.

Davis said this committee would not necessarily be for or against this expansion, but he believes discussing it is a necessary part of any conversation on improving healthcare.

“It’s important that we go ahead and have an open mind on everything, that we put all the facts on the table and have an honest discussion. We owe that to the people of South Carolina,” he said.

A study released earlier this year by the Kaiser Family Foundation estimates more than 100,000 uninsured South Carolinians would become eligible if the state expanded Medicaid coverage.

“I’m under no delusions that this means it’s going to happen. But I would be so grateful if we can do a real look at all aspects of how we provide healthcare in South Carolina and how we can do better by people,” Sue Berkowitz with South Carolina Appleseed Legal Justice Center said.

A potential Medicaid expansion would either need to gain the governor’s support to be signed into law or garner widespread enough backing in the Republican-dominated legislature to overcome a veto.

Gov. Henry McMaster has long opposed Medicaid expansion and believes studying the issue is unnecessary, according to spokesman Brandon Charochak.

“Rather than obligating future generations of South Carolina taxpayers to pay hundreds of millions of dollars in additional costs, the state’s emphasis should be on reducing poverty and expanding prosperity, thereby reducing the need for Medicaid assistance,” Charochak said in a statement.

If the committee’s formation is included in the final version of the budget, its recommendations would be submitted by Dec. 1, so the legislature could consider them when it returns for the start of its next regular legislative session in January.

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