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Making Poor People Suffer 

 South Carolina remains one of only 12 states that has not expanded Medicaid to provide health care insurance for its poorest residents. For more than a decade, the Palmetto State’s Republican governors have said, “No, thanks,” to billions in federal funds that could cover health insurance for the state’s most vulnerable. As reported exclusively by the Charleston City Paper, beefed-up incentives to expand Medicaid in the new federal coronavirus relief package make it an even better deal to cover thousands of uninsured South Carolinians. But, even practical policies are nonstarters with this crowd.

The sad reality is that without expanded Medicaid, more poor South Carolininans will die because they can’t afford to pay for health insurance.

Employer-sponsored health insurance covered about 45% of South Carolinians in 2018, according to the Kaiser Family Foundation. Others were covered by Medicare, Medicaid, individual and military plans.

The Affordable Care Act (ACA) has made the cost of health insurance a bit more bearable, but even for some hardworking people in S.C., it hasn’t been enough. More than 514,700 still lacked coverage altogether — about 12.7% of the state. The ACA intended to help low-income uninsured residents with Medicaid, but as a joint state and federal program, states had the chance to opt out. Not surprisingly, South Carolina leaders leapt at the chance to punish their poorest constituents.

These aren’t lazy freeloaders like Gov. Henry McMaster would have you believe. A healthy adult earning minimum wage in South Carolina without employer-provided health care and who can’t afford insurance does not qualify for Medicaid — unless he or she has kids.

The newest federal incentives to expand Medicaid would provide coverage for an estimated 200,000 people in South Carolina. For about $95 million per year from state coffers, federal dollars would pump another $790 million over two years to expand Medicaid.

Even a run-government-like-a-business Republican would tell you that’s a good deal.

Naturally, states that have expanded Medicaid showed dramatic drops in the uninsured rate, an average drop of 7.4% in states that implemented expanded Medicaid coverage after the passage of the ACA, according to the Kaiser Family Foundation. Expansion states also showed improved access to health care, reduced the cost of uncovered care and improved affordability of care.

Expanded Medicaid could even reduce racial and ethnic disparities in health coverage in South Carolina, where Black and Hispanic residents live in poverty at more than twice the rate of their white counterparts.

Yet, McMaster and his cronies seem determined to make poor people suffer under their watch.

One year ago, COVID-19 forced the state’s unemployment rate to more than triple almost overnight. While it has mostly recovered, the state’s forced reliance on employer-sponsored health coverage already left out hundreds of thousands in South Carolina, and the pandemic showcased how stubborn political obstinance can make a bad situation even worse.

Come on, South Carolina: Accept the federal money and expand Medicaid. People’s lives depend on it.