- BIG STORY: Health access in S.C. suffers, report says
- ROUNDUP: Deadlocked S.C. lawmakers miss budget deadline
- LOWCOUNTRY, Ariail: Logging
- BRACK: Read the Declaration of Independence
- MYSTERY PHOTO: Monument
- FEEDBACK: Send us your thoughts
Health access in S.C. suffers under Trump Medicaid cuts, report says
By Jack O’Toole, Statehouse bureau | More than 100,000 South Carolinians lost their health insurance coverage in the year since President Donald Trump signed roughly $1 trillion in Medicaid cuts into law through the “Big Beautiful Bill Act,” according to a new analytical report.
The Protect Our Care advocacy group contends those cuts, along with the decision to let Biden-era expanded Affordable Care Act (ACA) subsidies expire in the same bill, are fueling a “health care affordability crisis” that’s pushed more than 5 million people off Medicaid and ACA insurance rolls nationwide since June 2025.
In South Carolina, the report says more than 70,000 people lost Medicaid coverage, while roughly 45,000 have left ACA-subsidized private insurance plans.
Over time as more cuts come, the impact could raise premiums on remaining South Carolina insurees and cause some hospitals to close because of billions of dollars of unreimbursed costs to treat sick people, in-state experts say.
The report’s numbers are based on ACA enrollment figures from the U.S. Department of Health and Human Services and state-by-state Medicaid data compiled by Georgetown University.
More trouble may be ahead
But experts say the insurance bleeding isn’t done. The Congressional Budget Office estimates 15 million Americans will lose their health coverage when the law is fully implemented.
“Just one year after Trump and congressional Republicans made the largest cuts to health care in history to fund tax breaks for billionaires and big corporations on Wall Street, millions have lost the care they depended on to stay alive and healthy,” Protect Our Care President Brad Woodhouse said last month.
In response to critics, the Trump administration has said the changes are necessary to protect both programs from what it characterizes as widespread fraud. In particular, officials argue that insurance brokers systematically enroll millions of ineligible Americans in subsidized ACA plans.
They’ve sourced that claim to a report from the Trump-affiliated Paragon Health Institute that uses Census survey data to argue that sign-ups exceed the eligible ACA population by about 6 million people. But health care experts have questioned the study’s methodology, arguing, among other things, that Census estimates and hard enrollment numbers are apples and oranges that can’t be compared.
“The Trump Administration is taking decisive action to stop these corrupt schemes, recover taxpayer dollars, and hold fraudsters accountable,” HHS Secretary Robert F. Kennedy Jr. said in a June 27 social media post. “This is about protecting Americans from fraud and preventing your tax dollars from flowing to big insurance company profits.”
But Protect Our Care spokeswoman Maddie Twomey was quick to push back on those claims in a June 30 interview, noting that ACA premiums have “skyrocketed” over the past year, leading thousands to drop coverage they can no longer afford.
Specifically, Twomey pointed to Protect Our Care data showing that average ACA marketplace premiums in South Carolina have risen 235% since 2025, with some households facing even steeper increases. For instance, a 60-year-old couple earning $85,000 saw their annual premiums rise from about $7,000 to $29,000 — or more than one-third of their pre-tax income.
“The reality is that people in South Carolina are opening their health care bills and seeing them go up by hundreds or sometimes thousands of dollars,” Twomey said. “And the Trump administration is trying to call people fraudulent for being upset that their health care costs are rising.”
Intended, and unintended, consequences
South Carolina health care advocates told the City Paper they weren’t surprised by the report’s findings.
“We started doing outreach right after the bill was signed because it was clear how many people were going to lose their benefits in the first year,” said Sue Berkowitz, policy director of the Appleseed Center and a founding member of the health care advocacy group Cover SC. “That’s exactly what was intended when this bill passed.”
But Berkowitz says it’s the bill’s unintended consequences, including higher insurance premiums and shuttered hospitals, that will ultimately impact every South Carolinian.
The reason? When residents lose their health coverage, Berkowitz explained, they wind up getting their care in hospital emergency rooms that are required to treat them. So the hospitals pass those costs on to insured patients in the form of higher prices, which in turn lead to higher premiums. But there are limits to that strategy — and when hospitals can no longer shift enough of those costs onto private patients, they’re forced to close their doors.
According to Protect Our Care data, S.C. hospitals will lose $5.4 billion in additional uncompensated care costs under the bill between now and 2034, with five Upstate rural hospitals already at-risk for closure.
As for the administration’s claims of widespread ACA fraud, Berkowitz says she hasn’t seen it.
“This whole waste, fraud and abuse crap, excuse my language, is just an excuse to try to justify what they’re doing to kick people off the rolls,” Berkowitz said. “No, I don’t think South Carolina consumers are committing widespread fraud. Let’s start talking about what we can do to actually improve people’s lives.”
Jack O’Toole is Statehouse bureau chief for Statehouse Report and the Charleston City Paper. Have a comment? Send to: feedback@statehousereport.com
Deadlocked S.C. lawmakers miss budget deadline
By Jack O’Toole, Statehouse bureau | South Carolina House and Senate negotiators remained deadlocked over tax breaks and earmarks this week, allowing the new fiscal year to begin on July 1 without a state budget.
Until they can resolve their differences, agencies will continue to operate at last year’s funding levels. And state employees will continue to wait for the raises they were promised when each chamber passed its version of the spending plan earlier this year.
The key sticking point? Some $350 million in House-backed earmarks, or lawmaker-sponsored local spending projects. Senators, meanwhile, want to put about two-thirds of that amount toward a property tax cut for homeowners 65 and older instead.
“The Senate is absolutely committed to providing additional tax relief,” said Beaufort Sen. Tom Davis, a member of the six-person House-Senate negotiating committee. “If it’s a choice between earmarks … or funding property tax relief, for me, that’s an easy call to make.”
Other issues dividing negotiators include $150 million for cost overruns at Scout Motors’ state-subsidized manufacturing site in Blythewood, proposed studies on the environmental and economic impacts of data centers, and a one-year suspension of the requirement that bars and restaurants carry $1 million in liquor liability insurance.
After failing to make any meaningful headway at its June 30 meeting, committee members agreed to recess until July 14, while efforts to break the impasse continue behind the scenes.
House Ways and Means Committee Chairman Bruce Bannister, R-Greenville, told reporters that he thinks members broadly agree on policy, and should be able to work out their differences over the break.
“There are disagreements in the margins of how we do that,” Bannister said. “Which I think we’ll be able to do — not easily, but fairly efficiently — between now and the 14th.”
In other recent news
S.C. overhauls transportation agency. Gov. Henry McMaster signed into law a sweeping overhaul of the state’s transportation system, restructuring the S.C. Department of Transportation in an effort to speed road repairs and improve accountability.
State troopers, DNR increase patrols for Fourth of July. Law enforcement agencies across the state are urging residents and visitors to prioritize safety on both roads and waterways throughout the Fourth of July weekend.
S.C. sees some of the fastest rising wages in the region. South Carolina’s growth in personal income outpaced its Southeastern neighbors in the first quarter.
SCGOP preps for closed primary lawsuit with rules change. Leaders in the South Carolina Republican Party say a planned lawsuit over the state’s failure to “close” primary elections is imminent after adopting a rule change imposing new restrictions on who can run under the party banner.
Murdaugh double murder retrial to take place next year, judge rules. A new judge in South Carolina’s double murder case against convicted felon Alex Murdaugh, who is accused of killing his wife and son in 2021, on Monday set a retrial for April 2027.
State Ports says goodbye to its final Charleston cruise ship. The last cruise ship to call on Union Pier Terminal left downtown Charleston Tuesday evening as plans to redevelop the area as a mixed-use district move forward.
Logging
Award-winning cartoonist Robert Ariail has a special knack for poking a little fun in just the right way. In this week’s panel, he offers an outlandish, and tongue-in-cheek reference to how a colonial palmetto fort could have been built.
- Love this week’s cartoon or hate it? Did he go too far, or not far enough? Send your thoughts to feedback@statehousereport.com.
Brack: Homework for July 4: Read the Declaration of Independence
Commentary by Andy Brack | What better time for a careful, considered reading of the Declaration of Independence. Two hundred and fifty years after our founding fathers penned this document, it continues to inspire freedom movements around the world.
But we need to remind ourselves why patriots from New Hampshire to Georgia revolted in 1776 against a tyrannical monarchy. This is particularly relevant today when we have a president who seems to want to be the kind of king that our forefathers shrugged off during the Revolutionary War.
Just five years ago, this very same president was complicit in a violent anti-freedom assault on the United States Capitol. Hundreds of bloodthirsty zealots misused and misappropriated the fundamental principles enshrouded in American freedom by trying to rip apart our democracy in favor of the very tyranny our forefathers fought in the fields of Camden and King’s Mountain, the swamps of the Lowcountry and forts from Ninety Six to Sullivan’s Island.
Donald Trump left office two weeks later. Joe Biden restored order. Hundreds of the zealots were prosecuted and convicted. But Trump stewed on his 2020 loss, only to run again and win a second term in 2024. Then he pardoned the felons and wrought a year and a half of dizzying new assaults on our democratic institutions.
So yes, now is a great time to read the 1,339-word Declaration, particularly if you haven’t looked at it since high school.
You may know by heart the opening words of the document penned by Thomas Jefferson and others that espouses the values of “life, liberty and the pursuit of happiness.” You also may remember the part that follows and discusses how it’s the people’s right to alter or abolish a government that fails, which is oft-cited by those who threw the destructive tantrum and bludgeoned the Capitol on Jan. 6, 2021.
But they conveniently forgot the cautious words that followed. Perhaps they missed that day in civics class. Or maybe they were so hellbent on getting their own way that they were blinded by the wisdom of colonial leaders who first focused not on a violent overthrow of power, but on reason and intellect to devise a new system to create a safe nation where all could pursue happiness:
“Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed.”
The Declaration continued by offering a list of abuses by the King of England. As you read of compounding restrictions that denied liberty to colonists, it should dawn on you how our forefathers eventually corrected those abuses with a constitution that created a representative democracy that became the world’s beacon of freedom, a continuing experiment in liberty that changed the course of humankind.
Furthermore, the Declaration is remarkable in another way. It frames the patience of colonists who wanted better lives for their families. Compare their years of endurance to get redress of their grievances to the volcanic violence that erupted in the halls of freedom over a few hours in January 2021.
And so in 1776, 56 men from 13 colonies signed the Declaration of Independence. The oldest was Benjamin Franklin, then 70, of Pennsylvania. The youngest was Edward Rutledge, 26, of South Carolina.
The document ends like this: “And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.”
And that’s the difference between what happened back then and five years ago: One was bound with honor, community, faith, goodwill and justice. The other had none.
Celebrate this Fourth of July with family, friends, burgers, barbecue, hot dogs and honor. And relish our Declaration of Independence to marvel about how these united states came to be.
Andy Brack is editor and publisher of the Charleston City Paper and Statehouse Report. Have a comment? Send to: feedback@charlestoncitypaper.com
Monument
Here’s an out-of-the-way monument somewhere in South Carolina. Where is it? For bonus points, why is it important? Send in your best guess – and your name and hometown – to feedback@statehousereport.com. And if you have a mystery photo to share, send that along too (but tell us what it is because we’re horrible guessers.)
Last week’s mystery, “Part of a building,” showed part of the front of the Lonnie Hamilton III Public Services Building in North Charleston in which Charleston City Council meets.
Kudos to these sleuths who identified it: Jay Altman and Dalton Tresvant, both of Columbia; Allan Peel of San Antonio, Texas; Margaret Blackmer of Charleston; and George Graf of Palmyra, Va.
- SHARE: If you have a Mystery Photo to share, please send it to us – and make sure you tell us what it is!
Send us your thoughts
Please send us your thoughts about politics and policy in South Carolina, but make sure to leave phone numbers and hometowns to help us verify them for publication. We publish non-defamatory comments, but unless you provide your contact information – name and hometown, plus a phone number used only by us for verification – we can’t publish your views.
- Have a comment? Send your letters or comments to: feedback@statehousereport.com. Make sure to provide your contact details (name, hometown and phone number for verification. Letters are limited to 150 words.
Statehouse Report, founded in 2001 as a weekly legislative forecast that informs readers about what is going to happen in South Carolina politics and policy, is provided by email to you at no charge every Friday.
- Editor and publisher: Andy Brack, 843.670.3996
- Statehouse bureau chief: Jack O’Toole
We can use your help
We’re proud to offer Statehouse Report for free. For more than a dozen years, we’ve been the go-to place for insightful independent policy and political news and views in the Palmetto State. And we love it as much as you do.
But now, we can use your help. If you’ve been thinking of contributing to Statehouse Report over the years, now would be a great time to contribute as we deal with the crisis. In advance, thank you.
More
- Mailing address: Send inquiries by mail to: P.O. Box 21942, Charleston, SC 29413
- Subscriptions are free. If you want to subscribe, send us an email: feedback@statehousereport.com with the word “subscribe” in the subject. We hope you’ll keep receiving the great news and information from Statehouse Report, but if you need to unsubscribe, go to the bottom of the weekly email issue and follow the instructions.
- Read our sister publication: Charleston City Paper (every Friday in print; Every day online)
- © 2026, Statehouse Report, a publication of City Paper Publishing, LLC. All rights reserved.
Help keep the City Paper free.
No paywalls.
No subscription cost.
Free delivery at 800 locations.
Help support independent journalism by donating today.
