By Lauren Ratcliffe
Published Jan. 29, 2013
Doctors from across the state gathered in Columbia today to collectively lobby legislators to expand Medicaid eligibility under the Affordable Care Act.
White Coat Day was organized by the South Carolina Hospital Association and aimed to equip doctors to engage with their representatives and push for the state to accept federal money and expand the health program for lower income people.
About 75 doctors from across the state attended a meeting at the Statehouse.
Rep. Kris Crawford, a Republican from Florence and also an emergency room doctor, supports the expansion but expects the Republican caucus to vote as a bloc against the Medicaid expansion.
“The politics are going to overwhelm the policy. It is good politics to oppose the black guy in the White House right now, especially for the Republican Party,” Crawford said.
He encouraged the doctors to advocate the use of the budget to accomplish expansion of Medicaid, rather than passing additional laws.
Dr. Megan Baker Ruppel, medical director of comprehensive breast care at the Hollings Cancer Center in Charleston, talked about a working class woman who had treatment for breast cancer delayed for more than a year because she did not have coverage.
“She could be helped by this. It’s not politics, it’s not policy, it’s people,” Ruppel said.
The debate centers on a controversial provision in President Obama’s health care legislation. When the Supreme Court upheld most of the law last June, it modified the bill’s provisions on Medicaid making mandatory expansion unconstitutional and leaving the decision up to individual states.
Gov. Nikki Haley has said she is opposed to the expansion and would not support a decision to increase the program’s eligibility requirements. Tony Keck, director of the state Department of Health and Human Services, has said that the decision, from the state’s perspective, was less about giving people insurance and more about spending state and federal money wisely.
Under the Affordable Care Act, states can choose to expand Medicaid eligibility for all individuals living at or below 138% of the federal poverty limit — $14,494 for a single person or $24,645 for a family of three.
Currently, South Carolina covers children living below 200% of the federal poverty limit, pregnant women living below 185% of the federal limit and assistance to the blind, elderly or disabled living below 100% of the limit.
Keck estimated that expanding coverage universally would give coverage to about a half-million people and end up costing the state between $500 million and $2.6 billion.
Initially the federal government will bear the financial burden of any state’s expansion and by 2020 they will reduce their financial contribution to 90% — states will only ever be responsible for 10% of the costs for expanding Medicaid.
Several legislators have supported bills in favor, and in opposition to, the expansion and the debate is not expected to diminish any time soon.