This week, the South Carolina Senate takes up the 2013-14 state budget by reviewing the changes the Senate Finance Committee made to the House’s spending plan.  Senate leaders from all sides expect debate to be more peaceful than in the recession years, as state government enjoys a revenue surplus of about $683 million.

However, there will be points of contention over the $6.3 billion spending plan.  One of those will be the mainly partisan fight over Medicaid expansion, allowing three years of federally funded healthcare benefits extended to an additional 350,000 South Carolinians. The House rejected the idea of the state agreeing to the expansion; the Republican majority says it is an “Obamacare” overreach.  Senate Finance Committee members defeated the expansion by two votes.

Yet this debate is not over. Senate Democrats, bolstered by the support of South Carolina hospitals and medical community, say they are taking the fight to the Senate floor, by introducing an amendment to the budget bill.

Spokesman for Senate Democrats, Phil Bailey says, ”This is a three-year program which is going to be completely funded by the federal government, i.e. our tax dollars. Let’s take advantage of it, let’s expand it out to South Carolina’s working poor. We have an opportunity to close the uninsured gap by half.”

He echoes the argument of House Democrats: “These are our tax dollars and we want to keep them back here in South Carolina rather than have them go out of state to New Jersey, New York and California.”

Senator Shane Massey (R-Edgefield) says the expansion under the Affordable Care Act is far from affordable: “If anything it is making health care more expensive.  If it’s affordable it’s only because the government is paying for it.”

“There are real social and cultural costs to giving able-bodied people things for nothing,” Massey argues.  He says South Carolina, through the current Medicaid system, already provides medical coverage to the disabled, the elderly, and children.

“This is a significant departure from what we have known as Medicaid,” Massey says.

 The state can pull out of the program after three years, when the state’s part will begin t0 progressively increase to 10 percent by the year 2020.

Massey says he does not believe the program would stop then.

“Once an entitlement is given, you just don’t yank it way. That just doesn’t happen.”