By Frank Knapp Jr.
Contributing Writer

    Consensus is building among health care stakeholders in South Carolina on how to use new revenue from an increase in the cigarette tax. These funds should be used for health care in general and specifically to help those who cannot afford health insurance due to low income or pre-existing conditions.

For several years, The S.C. Small Business Chamber of Commerce, S.C. Appleseed Legal Justice Center and S.C. Fair Share have promoted legislation that would provide assistance to small businesses for health insurance premiums paid by employees with family incomes under 200% of the federal poverty level ($41,300 for a family of four). We believed that by cutting the cost of health insurance to the employer and to these qualifying employees, the employer could better afford to offer a group health plan to all staff.

Last month this concept was expanded by the Covering Carolina Collaborative, which represents doctors, hospitals, insurance companies and large businesses. The collaborative proposed that cigarette tax revenues be used to subsidize health insurance for low-income, uninsured South Carolinians either as individuals or within a small group plan. Advanceable, refundable tax credits would be available to individuals with family incomes of up to 250% of the federal poverty level ($51,625 for a family of four) or to their employers to be used for the purchase of approved health care insurance plans.

All parties also agree that the state could use cigarette tax or other revenue to expand Medicaid coverage to parents below the federal poverty level ($20,650 for a family of four) or expand the State Children’s Health Insurance Program with state or state and federal funds to cover children in families at up to 250% of the federal poverty level.

This consensus may boost the chances of passage of a cigarette tax this year. Using the new funds to help small businesses and qualifying individuals better afford or have access to health insurance will be a powerful incentive for legislative success.

However, effective use of a cigarette tax is only a part of the real health care reform that we need. Systemic reform will require more discussion about how to address the majority of uninsured who are not low income, how to reduce costs within the system and how to make health insurance affordable for those with pre-existing conditions. Plus, we need to set health care goals for South Carolina.

Recently the Colorado Blue Ribbon Commission for Health Care Reform released just such a comprehensive report for that state. That effort can be used as a model for such a commission here. the effort will require updated statewide health information collected for its use.

As we begin to set health care goals, The S.C. Small Business Chamber of Commerce believes that we need bold ideas in line with our common principles.

One of these principles is that our children are our most precious responsibility. This is why we support providing Medicaid to low-income children. But we draw artificial income lines for our responsibility when we should be agreeing that all South Carolina’s children should have guaranteed access to quality health care regardless of a family’s ability to pay and regardless of the health status of the child or other family members. The same principle of universal health care for seniors should be extended to all our children.

In addition to the health benefits, there are numerous economic benefits:

1. Low-income parents will no longer have their upward mobility blocked by concerns of losing health care for children if they exceed artificial income levels.

2. Parents with healthy children make better, more productive employees.

3. Job-shopping for benefits will end and employees will be more willing to work in small businesses.

4. Entrepreneurship will be advanced with the elimination of income concerns to pay for health insurance for children.

5. All families will be financially stronger thanks to lower insurance premiums for total family health coverage.

6. Small businesses will be better able to compete against big businesses for skilled workers.

7. Such a program will help attract business of all sizes to the state.

Designing guaranteed coverage for all of the state’s children can be accomplished in the same way as some other states already have. Private health insurance companies could participate in providing coverage to children in families above Medicaid limits.  

Let’s build on the consensus we are developing with aggressive new planning and bold ideas.

Frank Knapp is president and CEO of Columbia-based The S.C. Small Business Chamber of Commerce. Visit www.scsbc.org for information.

SUBSCRIBE | REPRINTS | CONTACT US

Phone: 843-849-3100    Fax: 843-849-3122