A program approved by the Trump administration requiring South Carolina adults with Medicaid to prove that they work or participate in various community engagement activities is likely to be eliminated under the new Biden administration before it even leaves the role.
“Healthy Connections Works” was approved by the Federal Centers for Medicare and Medicaid Services in 2019, but has not yet been implemented, according to the federal government. It would eventually have required adults with Medicaid coverage in South Carolina to prove that they spend at least 80 hours a month working or engaging in other productive activities outside the home, such as education, professional skills training or community service.
In a letter to the South Carolina Medicaid agency dated February 12, the Centers for Medicare and Medicaid Services outlined several reasons why the program was “unviable”.
“CMS has serious concerns about testing policies that create a risk of substantial loss of health coverage in the short term. The COVID-19 pandemic had a significant impact on the health of Medicaid beneficiaries, ”wrote CMS acting administrator Elizabeth Richter. “Taking into account the totality of circumstances, the CMS has preliminarily determined that allowing work and other community involvement requirements to take effect in South Carolina would not further the objectives of the Medicaid program.”
The state will have 30 days to send information in favor of meeting the work requirements.
Before its approval, three years ago, Governor Henry McMaster defended the plan, citing that jobs generate healthier lifestyles, financial independence and opportunities.
“Whenever possible, we should always strive to help South Carolina’s needy find their way to a lucrative job and away from temporary government assistance,” said McMaster in 2018.
McMaster’s office did not immediately answer questions about the federal decision on Saturday.
Ten states, including South Carolina, approved Medicaid’s job requirements under the Trump administration, but Arkansas was the only state to fully implement the rules, according to the Politico.
Meanwhile, critics argued that the plan failed to take into account the lack of available jobs, childcare or transportation.
Sue Berkowitz, executive director of the Appleseed Legal Justice Center in Columbia, has protested Medicaid’s job requirements since they were first proposed. If the rules had been implemented, she said her group would have challenged them in court.
“The premise that work makes people healthy was just ridiculous. No. When people are healthy, they can work, ”said Berkowitz. “Needless to say, McMaster’s office and our office have differing views on this. He was clearly following Trump’s lead … without doing the job of determining if that was really in South Carolina’s best interest. ”
At one point, the state Medicaid agency predicted that 180,000 adult Medicaid beneficiaries in South Carolina would be subject to labor rules, but that most of them already met the requirements or would qualify for an exemption. Former SC Medicaid director Joshua Baker estimated that less than 10,000 adults with Medicaid coverage would need to look for work or risk losing their health insurance.
These estimates are likely to be low now, considering the growth in Medicaid enrollment during the pandemic. Medicaid eligibility rules vary widely from state to state, and in South Carolina, existing rules make it difficult for childless adults to qualify for coverage, regardless of their poverty level. Even so, adult enrollment in the program grew substantially during the COVID-19 pandemic.
In December, more than 1.3 million Southern Carolinians were enrolled in Medicaid, representing a jump of about 90,000 beneficiaries since last March. About half of all Medicaid registrants in this state are children, but the biggest gains in enrollment growth have been seen among adults in the past year.
Catch up Lauren Sausser at 843-937-5598.