SC House Republicans offer alternative to Affordable Care Act

abeam@thestate.comFebruary 20, 2013 

  • S.C. House Republicans’ health care plan S.C. House Republicans reject Obamacare, which would allow states to spend more money on health insurance for the poor. Wednesday, they laid out their plan, which would spend:

    $20 million: including $6 million in state money, the rest from the federal government – to pay rural hospitals 100 percent of their cost for uncompensated care that they give low-income patients, a proposal Gov. Nikki Haley unveiled during her State of the State address.

    $35 million: including $10 million in state money, the rest from the federal government – for “Healthy Outcomes Initiatives,” whereby the state would pay hospitals for things like developing programs that would reduce expensive emergency-room visits.

    $10 million to go to the state’s 20 federally qualified health clinics. The clinics provide care for low-income people, including those who make less than 100 percent of the federal poverty level and otherwise would be ineligible for Medicaid or federally subsidized health insurance.

    $8 million to expand a tele-medicine program at the Medical University of South Carolina

    $7 million for the Optional State Supplement program, which helps “aged, blind or disabled persons” pay for community residential-care facilities

    $3 million for a program to help repay the student loans of doctors who agree to work in underserved areas of the state

— Instead of paying for more poor people to have health insurance, S.C. Republicans on Wednesday offered to pay hospitals more to keep poor people out of emergency rooms.

The Republican health care proposal would pay hospitals $35 million next year to steer the uninsured away from emergency rooms, which they often use for nonemergency care, and into free health clinics. Republicans want to give an additional $10 million next year to the state’s 20 federally qualified health clinics to help pay those clinics to treat those patients.

The plan, part of a proposed $23 billion budget for the state’s fiscal year that starts July 1, would not spend any new money on health care. Instead, the state would pay for it by using $62 million that the state Department of Health and Human Services received last year but did not spend.

The S.C. House’s Republican leadership is presenting the plan as an alternative to complying with the federal Affordable Care Act, commonly called Obamacare.

The Affordable Care Act allows states to expand Medicaid – the joint federal-state health insurance for the poor and disabled – to anyone who makes less than 138 percent of the federal poverty level, or about $15,000. In South Carolina, that add about 500,000 people to the state’s Medicaid program.

Democrats support the Affordable Care Act, saying it would help the poor and the state’s economy through the influx of billions of federal dollars.

However, Republicans, who control the House and state Senate, generally oppose Obamacare, saying it would be too expensive. While the federal government initially would pay all the program’s cost, after the third year that support would drop to 90 percent. The remaining10 percent would have to be paid by the state, costing more than $1 billion in total by 2020, according to estimates from state health officials.

“You could either insure everybody, or you could try to control spending and have better outcomes,” said state Rep. Murrell Smith, R-Sumter, chairman of the House Ways and Means health care subcommittee. “Everyone agrees there is excess cost in health care right now. Our job, what the state of South Carolina wants to do, is take that excess cost out by improving health and improving access.”

State Rep. Gilda Cobb-Hunter, D-Orangeburg, applauded Republicans for proposing to give more money to the health clinics, noting they care for the uninsured. But she said giving $10 million to health clinics is not enough to replace health insurance for the poor.

“I don’t see it as a substitute for Medicaid expansion,” she said. “But I do see it as a stopgap until the political rhetoric dies down and reality sets in.”

Other Democrats were less diplomatic.

Tyler Jones, spokesman for the S.C. House Democratic Caucus, called the Republican plan “insulting.”

“It doesn’t even insure one new person,” he said. “It’s a non-starter with Democrats or anyone who takes this issue seriously.”

In addition, the Republican plan includes:

• $20 million – $6 million in state money and $14 million from the federal government – to pay rural hospitals 100 percent of their cost for uncompensated care that they give low-income patients, a proposal Republican Gov. Nikki Haley unveiled during her State of the State address.

• $8 million to expand a tele-medicine program at the Medical University of South Carolina.

• $7 million for the Optional State Supplement program, which helps “aged, blind or disabled persons” pay for community residential-care facilities

• $3 million for a program to help repay the student loans of doctors who agree to work in underserved areas of the state

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