South Carolina’s Medicaid agency is requesting an extra $110 million next year– raising its overall budget to almost $6 billion.
Department of Health and Human Services (DHHS) director Tony Keck told a legislative subcommittee Thursday that the agency wants to slowly prepare for changes that would be required under the health care reform law starting in 2014.
Specifically, Keck wants to permanently add about 78,000 children to the state’s Medicaid rolls. These children are already eligible because their families’ income is under 133 percent of the poverty level. However, Keck says they are not enrolled for various reasons. He admitted DHHS did not reach out to those families in previous years.
“The (Legislature) appropriated money for the department to do that (in 2005),” Keck told the three members of the House Ways & Means Committee on the panel, “Over a course of several years, the department didn’t do a very good job of actually doing that. And you all took the money back because we weren’t spending it.”
Overall, DHHS is asking for nearly $110 million in new state funds, as well as $242 million to cover recurring costs that had been funded by one-time monies this year. That means South Carolina would set aside over $1.2 billion towards the program in total.
Keck, who took over DHHS earlier this year, said more than 90,000 children fall off Medicaid in South Carolina every year only to re-enroll within six weeks. “That has created a huge administrative churn… It created hundreds of thousands of extra man-hours of work. It created delayed payments to providers. It was a big problem.”
DHHS officials plan on using the federal “express lane eligibility” process to find those families whose children meet Medicaid’s requirements, but are not enrolled. That would involve matching welfare records with Medicaid rolls. Medicaid costs are overseen by the state, with the federal government traditionally offering a $1.60 match.
Maggie Michael, executive director of the South Carolina Children’s Hospital Collaborative said that effort was overdue. “The agency has never said ‘Let’s look at all the kids on school lunches. They’re probably eligible for Medicaid.’ They’ve never taken that effort.”
“Express lane eligibility” was created by Congress in 2009 for the Children’s Health Insurance Program, which is enveloped under Medicaid in South Carolina.
The agency says it is trying to anticipate a massive increase in Medicaid recipients once the Affordable Care Act takes effect in 2014. The plan is to gradually increasing the number of people in the system over the next two years. By 2014, the state is required to start covering adults within 133 percent of the poverty line (the state currently covers up to 50 percent).
According to DHHS projections, over 924,000 people will be enrolled in the state’s program in fiscal year 2013. However, two years later, that number is expected to grow to 1.46 million.
Michael said there is a reason the first step of this expansion is children, “Kids are really cheap,” she said, “Kids are probably a third of the cost of adults on Medicaid. If (Keck’s) going to start gearing up, it’s fiscally a good move to gear up on the cheap population.”
Legislators on the panel, which consisted of Reps. Murrell Smith (R-Sumter), Bill Herbkersman (R-Beaufort), and Harry Ott (D-Calhoun) said it was too early to know if the agency would get the request. It’s expected to be included as part of Governor Nikki Haley’s executive budget.