The South Carolina Appleseed Legal Justice Center and the Georgetown University Center for Children and Families says a proposal to impose work requirements on South Carolina parents receiving Medicaid could cause many of the state’s poorest families to lose their health coverage altogether
South Carolina is considering a work requirement without first accepting the Medicaid expansion under the Affordable Care Act. Gov. Henry McMaster has asked the state Department of Health and Human Services to submit a waiver asking the federal government for permission to require able-bodied adults receiving Medicaid coverage either show they have a job or are working to obtain one.
Columbia pediatrician Dr. Deborah Greenhouse said a parent losing health coverage could also affect their children. “This impacts entire families. What happens to a parent impacts what happens to the children.”
South Carolina officials have not yet submitted their formal plans for changing the work rules, which would come in the form of Section 1115 demonstration waiver requiring approval from the federal Centers for Medicare and Medicaid Services.
Appleseed executive director Sue Berkowitz said the work requirement would hit harder in South Carolina’s rural communities. “South Carolina has not been taking care of our low-income families and we’ve made such progress with our children, at least in the healthcare arena making sure they have coverage.”
The work requirement would hit harder in South Carolina’s rural communities and small towns, where families are more likely to use Medicaid than those in urban areas according to a study from Georgetown CCF and the University of North Carolina. Jobs remain harder to find in these regions: Nine of the 11 South Carolina counties with the highest unemployment rates in 2017 were rural counties.
Berkowitz also argued the changes would not account for those healthy individuals who are the sole caregiver for an elderly parent and are not able to spend time at a job or to afford a caregiver.