The sad case of Medicaid expansion

At the recent Republican National Convention South Carolina Governor Nikki Haley took the stage.  “Sadly, the hardest part of my job continues to be this federal government, this administration and this president,” she said.

But a story in today’s Charleston Post & Courier clearly shows that the hardest part of the Governor’s job is convincing state legislators not to do what is in the best interest of South Carolina. 

According to the story Haley and Tony Keck, who heads the state’s Department of Health and Human Services (SCDHHS), have been meeting and talking with legislators to convince them to vote against expanding Medicaid in the state to cover up to 600,000 uninsured South Carolinians. 

Under Obamacare the feds would pick up all the cost for the expansion for the first three years and 90% after that so the uninsured at or below 138% of the federal poverty level could get the healthcare they desperately need.  Small businesses employing these working poor would benefit from healthier workers that would no longer need covering under employer healthcare plans.   Premiums for everyone would be helped by eliminating the hidden premium tax we all pay for the uninsured.  Healthcare providers would benefit from the increased revenue.  And the economic boost to the whole state’s economy would be enormous. 

But Haley wants the state to reject the $13 billion in federal money over the next six years because, she says, it would hurt the state in the long run. 

Haley complains that the state can’t afford the expansion.  She cites a highly criticized study paid for by Keck’s agency.  In analyzing this report John Ruoff of The Ruoff Group concludes, “As the General Assembly explores a Medicaid expansion, it should do so with realistic numbers based on empirical research and taking into account all costs and savings directly attributable to an expansion and not just SCDHHS costs and savings. To date, SCDHHS has failed to provide estimates of those other savings.”

The Haley administration also contends that the Medicaid program doesn’t provide the most healthcare for the lowest cost.  But instead of crafting a new approach and asking the feds for waivers to implement a more “cost effective” Medicaid program as it claims it wants, Haley and Keck would rather do the political work of convincing the legislature and public that an expansion is not good for the state. 

Sadly for South Carolinians, the hardest part of our job is seeing the health of our citizens and economy suffer at the hands of partisans looking to make national names for themselves.