For 50-year-old Kelly Stiles, who worked since she was 16 years old until her job went away and her health failed, the S.C. House vote Tuesday to not expand Medicaid is not about somebody else.
“The only chance I had at Medicaid, to get health coverage, was this,” Stiles said Wednesday. “People talk all day about Obamacare and how bad it is for America. Well, that’s me. I’m one who needs Obamacare. Without it, I got nothin’.”
Then she did what sick poor people without health insurance do – cry and pray.
Tuesday’s vote in the House is a clear sign that about a half-million of South Carolina’s poorest residents will not become eligible for the expansion of Medicaid that would have happened if the state’s politicians agreed to that part of the federal Affordable Care Act, commonly called Obamacare.
Locally, the effects are in the tens of thousands. Among almost 250,000 people in York County, one in seven live in poverty. In Chester County, with 33,000 people, one in four are in poverty.
The new Medicaid rules would have set the bar for eligibility at about $32,000 income a year for a family of four. In Chester County, the census shows, $32,000 is the average income. About half of Chester County would have become eligible.
House Republicans voted against Medicaid expansion. House Democrats voted for it. The Republicans, with far more votes, claimed more Medicaid for more poor would cost too much – almost $2 billion by 2020 – and deliver too little in services to make people healthier.
Many Republicans just don’t like the federal government telling South Carolina what to do.
The fact that South Carolina is 46th out of 50 states in health care remains as much a fact as the state’s hundreds of thousands living in poverty without health care.
The poor remain broke and without coverage.
Stiles and her best friend Sally Slater – they are so close that they call each other sisters – had closely watched the decision about Medicaid. The only political party they belong to is the poor party.
“I get Medicaid, and the co-pays for medicine and all I can’t even pay that, but without it the only health care I would have is prayer,” said Slater, 53. “Kelly doesn’t get (Medicaid), so she has to pray she don’t get sicker.”
Stiles, who said she worked in warehouses and other physical jobs until her health failed, said she is already sick without a way to get treatment. Her last income was picking up aluminum cans.
“I guess they want me to curl up and die,” Stiles said of the politicians who voted against Medicaid expansion. “It’s like a slap in the face to everybody who ain’t got nothin’.”
The Center for Health Policy & Inequality Research at Duke University released a study last year that declared York County’s health care network “insufficient” to meet the needs of the poor. The decision by legislators means “insufficient” will remain in York County.
What also remains is places the poorest go for medical care, whether politicians want to expand Medicaid or not.
The North Central Family Medical Center on Rock Hill’s Saluda Street, a federally qualified center, saw patients Wednesday. The center sees at least 10,000 patients each year, many of whom are Medicaid recipients. Patients pay on a sliding scale.
The waiting room was filled Wednesday with the poor who have no votes in the Legislature, but do have contusions and cancers and difficulty making a co-payment.
York County’s free clinic, Palmetto Volunteers in Medicine, saw more than 2,000 patients in 2012. Dozens of doctors and nurses and clinicians donated time and expertise to those who do not qualify for Medicaid. Its waiting room was full Wednesday.
People such as Charles Ellis were there.
“I work, but they don’t offer health insurance, so I have no insurance,” he said.