How Everyone in South Carolina Will Suffer From Medicaid Work Requirements

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Last week, we blogged about how many people support work requirements and other measures to reduce Medicaid coverage because they believed lies about Medicaid and the people on it. Contrary to what many people think, most people on Medicaid are either unable to work (children, the elderly and people with disabilities) or need the coverage to support their employment as they don’t earn nearly enough to pay for private insurance.

Though some may be unmoved by these arguments and be somewhat apathetic to people losing Medicaid, it’s an issue that affects everyone. When the Medicaid rolls shrink, it is harmful to everyone—beneficiaries, hospitals, those on private insurance and more. Here’s how:

The coverage boost Medicaid provides sustains rural hospitals.

In South Carolina, over 1.2 million—about one quarter of the state’s 5 million residence—are on Medicaid. In 2015, about 247,000 of those covered lived in rural areas and a staggering 33 percent of the rural population were on Medicaid. With one in three rural South Carolinians covered by Medicaid, hospitals and healthcare providers are more strained by Medicaid cuts than providers in metro areas. According to a fact sheet by Families USA, more than 75 percent of rural areas already suffer from shortage of primary care professionals. Cutting Medicaid puts these provider’s revenue further at risk, making it financially impossible to continue practicing.

The consequences of inadequate Medicaid funding can already be seen in South Carolina, where 3 rural hospitals have closed since 2010: Bamberg County Memorial Hospital, Marlboro Park Hospital (Bennettsville), and Southern Palmetto Hospital (Barnwell).

When Hospitals Suffer, Everyone Suffers.

Our healthcare system, like the economy in general, doesn’t limit financial suffering to low-income people. When a hospital gives care to someone without insurance, they have to increase the costs for those who have private insurance to compensate. Similarly, when a hospital closes, it’s not just low-income people who will suffer from that closed facility, but everyone in that community who relied on that facility for care and employment.

Work Requirements are basically cuts to Medicaid—and thus could start this vicious cycle.

Since Arkansas put in place their Medicaid work requirements in September 2018, over 18,000 people have lost coverage with many of them working full-time and simply being unable to navigate government bureaucracy. Following the example of these case studies, SC Appleseed and the Georgetown Center for Children and Families (CCF) estimates that 5,000 Medicaid beneficiaries in South Carolina will lose coverage in the first year alone of work requirements, with upwards of 26,000 losing coverage in the fifth year of implementation. With so many people losing coverage, hospitals will care for more people without insurance, which will increase costs for everyone and make it difficult for rural hospitals to make ends meet.

Because we know almost for certain that people will lose coverage, even if they’re eligible, the proposed work requirements would go one step farther to increase uncompensated care and ensure further cuts to the Medicaid funds received by hospitals across the state, continuing the vicious cycle of hospital closures in our state.

Everyone should oppose the state’s work requirement rule

Work requirements aren’t just an attack on low-income people but will have sweeping consequences to everyone, no matter their age, race, income, or political beliefs. For that reason and many others, we urge everyone to oppose this new rule. If you feel the same way, the comment period for this rule has been extended to February 4th. You can leave a comment at the link found here.