Governor Henry McMaster’s administration wants to come up with a plan to implement Medicaid’s job requirements for low-income adults in South Carolina, even after the federal government announced in February that those requirements would likely be eliminated soon.
McMaster argued that employment not only helps families financially, it also makes them healthy. Another key point in your government’s argument for imposing job requirements is that the current eligibility rules create “an irrational incentive” for low-income adults to remain poor, because extra income can kick them out of the Medicaid program and put them on in a health insurance coverage gap. . ”
In a prepared statement, SC Medicaid spokesman Jeff Leieritz said that this “creates an obstacle to the ability of low-income adults working to rise above the poverty level”.
South Carolina was one of several states authorized by former President Donald Trump to link work requirements to the low-income health insurance program. “Healthy Connections Works” would eventually require 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 school, vocational training or community service. The work rules have not yet been implemented.
Now, it seems unlikely that they will ever be. In a letter to South Carolina’s Medicaid agency dated February 12 – just over three weeks after President Joe Biden took office – the Federal Centers for Medicare and Medicaid Services set out several reasons why the work rules were “unworkable” , including the fact that the ongoing COVID-19 pandemic has had a significant impact on employment opportunities. McMaster’s Medicaid agency had 30 days to respond.
In a letter dated March 11, the department did so. In his response, SC Medicaid’s acting director, T. Clark Phillip, pointed out that some adults in South Carolina fall into a gap in insurance coverage because they earn a lot of money to qualify for Medicaid coverage, but not enough to qualify for a discounted HealthCare plan. gov.
Job requirements, he wrote, provide “a critical path to financial independence for low-income workers, removing the current financial disincentive to earn above 67% of the federal poverty level”, at which point they would normally make a lot of money to be approved for Medicaid coverage in South Carolina.
Work requirements, if implemented, would allow these adults to earn more and maintain their Medicaid plan, even if they exceed the income ceiling. Once their wages equaled or exceeded the federal poverty level – which was set at $ 12,760 for a single adult last year and varies by family size – they would qualify for subsidies through the health insurance market. federal, which offers private plans at great discount rates.
In short, the Medicaid agency argued that job requirements would help adults fill the coverage gap.
Sue Berkowitz, director of the SC Appleseed Legal Justice Center, said the only reason the coverage gap exists is because the McMaster administration and conservative lawmakers at the Statehouse are not going to expand Medicaid’s eligibility under the Affordable Care Act.
When Congress passed the broad health care reform bill in 2010, lawmakers wanted everyone in the country whose income to fall below 100% of the federal poverty level to qualify for Medicaid coverage. But a 2012 US Supreme Court decision left the expansion of Medicaid eligibility to each state. Nine years later, South Carolina is one of the remaining 12 states that have not expanded Medicaid. In 39 states and the District of Columbia, the coverage gap does not exist because all adults living below the poverty level qualify for a Medicaid card.
“There is no discouragement” to make more money, said Berkowitz, who opposed Medicaid’s job requirements from the start. “People are not working for a sub-poverty income on purpose. People are working for a sub-poverty income because those are the jobs that are available to them ”.
McMaster spokesman Brian Symmes said that expanding Medicaid to close the insurance gap in South Carolina is an “over-simplification that rules out the need for the state to remain fiscally responsible”.
“The main component of this initiative (Healthy Connections Works) is to encourage South Carolina residents to find a lucrative job or increase their education,” said Symmes. “Simply expanding Medicaid would be irresponsible from a fiscal point of view and would have the opposite effect to the governor’s ultimate goal, which is to lift South Carolina’s people out of poverty.”
It is unclear how long it will take the federal government now to decide the final destination of Medicaid’s job requirements. If South Carolina considers that the program will be eliminated, it may request a hearing to challenge that determination.
From the beginning, the plan to implement these rules in South Carolina and elsewhere faced significant legal challenges. In related news on Thursday, the United States Supreme Court canceled the next oral arguments scheduled for March 29 involving Medicaid work requirements in Arkansas and New Hampshire.
Catch up Lauren Sausser at 843-937-5598.