Democrats in the South Carolina House are pushing for Republicans to grow Medicaid coverage in the Palmetto State, but GOP leaders insist they do not want to take on the steadily increasing costs the expansion would bring.
The Affordable Care Act would grow Medicaid to include all adults living within 138 percent of the poverty line. However, a U.S. Supreme Court ruling last summer gave states the ability to opt out of that expansion by not accepting federal money. In South Carolina’s case, Gov. Nikki Haley and other Republicans say they do not want the additional money because of the strings that would be attached.
The federal government would cover the entire cost to add roughly 250,000 more South Carolinians to Medicaid rolls from 2014-2017. States would then have to cover 10 percent of the cost after 2017. In a press conference by House Democrats Tuesday, Rep. Todd Rutherford (D-Columbia) called that the “deal of a lifetime.”
“This is simple math. We know that most South Carolinians, if offered a raise for the next three years, would take that raise even if their boss told them that after three years… (it’s) unknown whether they’ll keep doing it or not,” he said.
But House Majority Leader Bruce Bannister made it clear in a statement that Republicans who control the Statehouse would not expand Medicaid. “The House Democrats have fallen into their comfort zone again, calling for higher taxes, more spending, and a massive increase in government dependency. To (Rep.) Rutherford, this is ‘a good deal’. A closer look shows it is anything but a deal for taxpayers.”
Democrats pointed to a report by the South Carolina Hospital Association that claimed the additional $11.2 million in federal money would create 44,000 new jobs in the state. Rep. James Smith (D-Columbia) said the extra federal aid would help provide enough tax revenue to cover South Carolina’s costs, which would be close to $1 billion more by 2020. Republicans have questioned that report’s methodology, noting the Hospital Association stands to benefit from the expansion.
Rep. Murrell Smith (R-Sumter), who chairs the House subcommittee that oversees the Medicaid budget, says there’s barely enough money to pay for the program’s growing costs even now. “If we have expansion… it’s going to be an obligation that’s unsustainable in South Carolina,” he said Tuesday, “We’re going to have a decision as to whether we’re going to want to fund education, infrastructure, corrections, law enforcement, or continue to grow Medicaid.”
The Department of Health and Human Services— the agency that runs Medicaid in South Carolina— has requested an additional $194 million this year alone, while budget analysts only project $292 million in additional revenue for the state’s entire budget.
But Rep. Gilda Cobb-Hunter (D-Orangeburg) said South Carolina lawmakers could find the money if they really wanted to, “Just as we came up with money to bring Boeing and BMW and all these other (companies) here, we think the people of South Carolina are just as worthy.”
Smith said he also does not want South Carolina to increase its reliance on Washington during a time when debt and budget fights are becoming increasingly toxic and uncertain.