Gov. Nikki Haley has picked one of her former staffers to replace the outgoing director of South Carolina’s Medicaid agency.
Haley on Monday nominated Christian Soura to lead the state Department of Health and Human Services, which is responsible for overseeing Medicaid services and providers in South Carolina. He will replace current director Tony Keck, who plans to become senior vice president of Tennessee-based Mountain States Health Alliance later this month. The governor appointed Keck to his post when her term began in 2011, hiring him away from a similar job in Louisiana’s state system.
“It was a matter of time before the private sector stole him away from us,” Haley told reporters in announcing the changes. “And they are certainly lucky. But I will tell you, South Carolina will be forever grateful to Tony Keck.”
Keck may have been the most visible Cabinet director in Haley’s administration. He inherited an agency that had run up a $228 million deficit one year earlier and recommended lower reimbursement rates for hospitals while increasing Medicaid recipients’ co-pays. After stabilizing the agency’s deficit, he then convinced state lawmakers to adopt “express lane eligibility” that allowed more than 92,000 children whose families were receiving food stamps to automatically apply for Medicaid coverage. Keck promoted the expansion as a way to reach those who did not realize they were eligible for government-sponsored health insurance.
That expansion and a sputtering economy that brought more people onto Medicaid rolls was a big factor in the agency’s budget steadily growing from $727 million in 2010 to more than $1.1 billion this past year. However, Democratic lawmakers frequently criticized Keck for siding with Gov. Haley on refusing to expand the eligibility requirements for Medicaid. The director had argued the state would not be able to afford the additional strain an estimated 200,000 more people would put on the system.
“I’m just so pleased and relieved that Christian is taking this job after me,” Keck said. “I don’t think there’s anybody else in the United States who’s better positioned to really take us to the next level. And if we thought the last four years in healthcare were busy, the next four years are going to be even more important and busier.”
Soura had been the governor’s top advisor on the budget the past three years before transitioning over to DHHS in September. He also helped craft the governor’s efforts to create a new Department of Administration, which eventually passed this spring after years of debate. The governor herself referred to Soura as “the man behind the curtain” in her office.
“You’re going to continue to see much of the same,” Soura told reporters. “Tony and I have worked together these last four years to put together these initiatives. There’s going to be a real sense of continuity as we move into the second term.”
Prior to working in Haley’s administration, Soura was the secretary of administration for former Democratic Pennsylvania Gov. Ed Rendell.
Haley also hinted that other Cabinet heads could be leaving before her second term begins in January. “You’ll see some stay. You’ll see some go,” she said in response to a reporter’s question. “It’s like a business.”