Survey finds majority in SC support Medicaid expansion

jholleman@thestate.comMarch 6, 2013 

— More than half of older adults in the state disagree with Gov. Nikki Haley’s plan to turn down Medicaid expansion, according to a survey by the AARP.

The survey found that 54 percent of the respondents support expanding Medicaid to cover low-income adults. A U.S. Supreme Court decision last summer allowed states to opt out of the Medicaid expansion provision of the federal Affordable Care Act. Haley has pledged not to accept the expansion, saying its an extension of a wasteful federal program.

Leaders in 17 states have indicated they plan to turn down the expansion, which would provide health coverage for adults making less than 138 percent of the federal poverty level. That’s about $15,000 annual income for a single adult, or about $32,000 for a family of four.

AARP, which is advocating for expansion, has commissioned surveys in several states. South Carolina is the second state to release survey results. In North Carolina, 58 percent favored expansion.

“Expanding Medicaid will help our state’s workers who’ve lost their jobs or are struggling in jobs without health benefits,” said Teresa Arnold, AARP South Carolina legislative director. “For older workers hit hardest by the recession and out of the workforce longer than younger workers, this is especially important.

“Expanding Medicaid will give people without insurance access to preventive care that can reduce the need for expensive emergency room care, and ease emergency room overcrowding.”

The survey also found that 88 percent of residents consider the federal Medicaid program extremely, very or somewhat important, and 64 percent felt the state should used proceeds from the 2000 tobacco settlement to expand Medicaid in the state.

The survey, conducted in February, included 800 telephone interviews with registered voters in the state 45 years or older. It has a margin of error of plus or minus 3.5 percent.

The vast majority of respondents (80 percent) were white. Most (90 percent) also had health coverage, and thus wouldn’t benefit directly from the expansion. Estimates of the uninsured in the state have hovered between 16 and 20 percent in recent years.

The expansion would provide health insurance coverage for an estimated 329,000 South Carolinians. The federal government would pay 100 percent of the expansion cost for the first three years, dropping to 90 percent by 2020.

A University of South Carolina study estimated accepting expansion would pump $11.2 billion federal dollars into the state’s economy and create 44,000 jobs. Tony Keck, director of the Medicaid-coordinating state Department of Health and Human Services, estimates the state’s share of the expansion cost would be $1.7 billion by 2020.

Haley and Keck have spoken out against the expansion, but the state Legislature will have a say in the decision. Several bills have been introduced — some requiring the state to turn down expansion, some requiring the state to accept expansion.

In budget hearings, no funds have been set aside to pay for the administration of expansion, which even in the early years would be an expense that falls on the state. While some Republicans have expressed reluctance at turning down federal funding, even those leaning towards accepting expansion have said they don’t expect to have enough votes to override a veto by Haley.

The voices in favor of expansion include AARP, S.C. Hospital Association, S.C. Primary Health Care Association, American Heart Association and United Way. They have been buoyed by changes in the stances on expansion by Republican governors in several states, including Florida, New Jersey and Arizona.

At state Senate subcommittee hearings on the issue, testimony by physicians was split. The S.C. Medical Association has taken a nuanced approach.

“While the SCMA agrees with finding solutions to provide health care to all South Carolinians,” the association said in an official statement in December, “we are concerned that the Medicaid expansion is a temporary and unsustainable fix that is not the solution for the long term health issues facing South Carolina.”

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