[image-1] A new study shows that 194,000 South Carolinians would qualify for Medicaid if state leaders opted to expand the program under the Affordable Care Act.

The number of uninsured people in the Palmetto State would drop from 660,000 to 466,000 under a full implementation of Medicaid expansion, according to a report released Wednesday by the Urban Institute, a Washington, D.C.-based think tank.

Medicaid is a joint federal and state health insurance program for low-income individuals.

The study projects that 16.4 percent of South Carolinians will be uninsured in 2019. The number would drop to 11.6 percent with the expansion.

The 2010 Affordable Care Act was initially written to provide states with billions of federal dollars for Medicaid coverage to citizens and residents who make less than 138% of the federal poverty line (or less than $16,753 in 2018 dollars).

A 2012 Supreme Court decision allowed for states to opt out of the expansion without risking their pre-ACA Medicaid funding.

Eighteen other states have not adopted the expansion as of now.

“If these states expanded Medicaid coverage, they would see increases in their insured populations, a reduction in uncompensated care costs, and increased state spending fully or largely offset by savings in other areas,” the report says.

“Not in South Carolina,” said then-Gov. Nikki Haley at a CPAC conference in March 2013, before most of the ACA provisions took effect in January 2014. “Do you know what I’m saying? As long as I am the governor of South Carolina, we will not expand Medicaid on President Obama’s watch. We will not expand Medicaid ever.”

The Urban Institute study found that federal spending on Medicaid, the Children’s Health Insurance Program, and ACA marketplace subsidies would go up by about $1.3 billion with the Medicaid expansion in 2019. The federal government would pick up 93 percent of the Medicaid expansion tab that year, and 90 percent in subsequent years, according to the federal Medicaid website.

South Carolina would only need to chip in about $111 million to cover the 194,000 newly-eligible citizens in 2019, according to the study.

“The 32 states that have already expanded the program have fewer uninsured residents, lower uncompensated care costs, and experienced net gains in state budgets,” according to the report.

Gov. Henry McMaster remains unconvinced.

“Not expanding Medicaid has proven to be the right choice for South Carolinians,” said Brian Symmes, a spokesman for Gov. McMaster, in an interview with The Post & Courier in November, “and the governor doesn’t believe there is any reason to reconsider that decision.”