South Carolina Medicaid History and Facts

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Initial Medicaid Implementation: South Carolina implemented their Medicaid program in July of 1968. When the program began the state did not offer a program for medically needy individuals. The state had unique needs because of the high rates of poverty. Despite this issue and the less professional state government, the state participated in the Kerr-Mills program. The state only had an average of 411 monthly members in the previous program with approximately 3,000 individuals assisted by the program annually. The program spent approximately $1.2 million over the course of the program’s existence.
Key Medicaid Political Issues: South Carolina has made significant progress in the area of Medicaid and maternal health. The state has implemented several programs including the Birth Outcome Initiative which is a project with the Medicaid agency and commercial insurers that established a policy of non-payment for early elective deliveries. The state saw significant savings from this initiative and through more community care programs that were established to treat women before, during, and after, childbirth. Despite these innovative efforts to improve maternal mortality, the state has been a leader in working to end payments to planned parenthood and other abortion providers from receiving state Medicaid funds. South Carolina has a high rate of poverty, meaning that the state receives a high matching rate for their program and more people are eligible for the income based categories of eligibility. South Carolina renamed their Department of Health and Human Services Finance Commission to the South Carolina Department of Health and Human Services in 1995.
Medicaid Expansion Implementation: South Carolina has not expanded Medicaid. The state has been under the control of both Republican governors and a Republican dominated legislature since 2012. In 2018 discussion began over whether the state would expand Medicaid through a ballot initiative following the successful attempts in other states. The ability for the state to expand through this option is doubtful because the state needs the legislature to pass the ballot initiative in order for the option to appear on the 2020 statewide ballot. In 2017 the South Carolina legislature accidentally passed a resolution in support of Medicaid expansion as part of a resolution welcoming the new governor. The legislature quickly reversed the resolution.
General facts about South Carolina Medicaid:
Medicaid program name: Medicaid
CHIP Program name: Healthy Connections Kids
Separate or combined CHIP: Medicaid Expansion
Medicaid Enrollment: 1.02 million (2018 estimate)
Total Medicaid Spending: $6.2 billion (FY 2017 estimate)
Share of total population covered by Medicaid: 19%
Share of Children covered by Medicaid: 40% (estimate)
Share of Medicaid that is Children and Adults: 77%
Share of Spending on Elderly and people with disabilities: 55%
Share of Nursing Facility Residents covered by Medicaid: 62.5%
FMAP: 70.7%
Expansion state: No
Number of people in expansion: N/A
Work Requirement: None


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