Republicans in the U.S. House voted this month to cut $880 billion over 10 years from programs overseen by the chamber’s Energy and Commerce Committee, which include Medicaid. President Donald Trump has pledged not to touch the health care benefits. (Stock photo via Getty Images)
President Donald Trump is right: Congress should not touch Medicaid.
The federal/state health insurance program for the poor and disabled provides coverage for 1.1 million South Carolina children and adults.
Medicaid covers about 60% of all births and 63% of all nursing-home patients in South Carolina.
Unfortunately, Medicaid is on the chopping block.
On Feb. 13, the U.S. House Budget Committee voted to seek at least $880 billion in cuts from programs under the purview of the chamber’s Energy and Commerce Committee, which include health care coverage. Critics warn such deep cuts aren’t possible without slashing Medicaid.
That’ll hit South Carolina hard.
In 2022, Medicaid spending totaled $8.9 billion in South Carolina, according to KFF, a health policy research organization. Federal funding accounted for $6.7 billion of that figure — or 75.4% of overall Medicaid spending.
Any federal Medicaid cut is not only going to potentially deprive low-income South Carolinians of health-care coverage but it’s going to hurt the state’s economy as well.
Republicans want to slash Medicaid for the poor to pay for tax cuts that overwhelming benefit the wealthy.
Let’s be clear about this: Congress and state leaders should be building up Medicaid in South Carolina, not tearing it down.
It’s long past time that we do right by our most vulnerable South Carolinians.
Uninsured and medical debt
The problem in South Carolina is not that too many people have health insurance.
The opposite is true: We have one of the highest uninsured rates in the nation, according to KFF.
Since March 2023 when COVID-era Medicaid initiatives ended, our state has taken 443,933 South Carolinians off the Medicaid rolls, according to KFF.
An estimated 521,660 South Carolinians under age 65 lack health insurance, according to data from the U.S. Census Bureau.
In other words, about 9% of our S.C. population is uninsured compared to the 3% uninsured rate in a state like Massachusetts.
We rarely stop to ask South Carolina’s elected officials why, under their leadership, our state ranks so far below most other states in the nation in so many categories of well-being, including health care coverage.
Perhaps it’s time we started asking.
One reason South Carolina has so many uninsured people is because our state remains one of only 10 states in the nation that stubbornly refuses to expand Medicaid eligibility.
That could draw down billions in federal funds to provide health care coverage for an additional 360,000 low-income South Carolinians, according to reporting by the SC Daily Gazette’s Skylar Laird.
By not expanding Medicaid, South Carolina has rejected $17.6 billion in federal funds in the past 10 years. That would not only help struggling South Carolinians obtain health insurance but it would provide a substantial economic boost to our state.
Our state’s refusal to expand Medicaid coverage may explain why South Carolina has the nation’s third-highest rate of medical debt in collection, according to the Urban Institute.
Unexpected ally
Struggling South Carolinians have found a perhaps unexpected ally in President Trump.
Medicaid, he said, should be off the table.
“Medicare, Medicaid — none of that stuff is going to be touched,” Trump said in an interview with Sean Hannity last week. “We won’t have to.”
Trump told Fox News that Social Security, Medicare and Medicaid are “going to be strengthened.”
It may be difficult to think of Trump as the protector of Medicaid, but he committed to it, and he should be taken seriously.
It’s true, however, that Trump sent mixed messages a day later by also endorsing the House budget plan which could do exactly what he said it shouldn’t — cut Medicaid.
Even as Republicans on the federal level plan to gut Medicaid, we’re seeing some hopeful developments in South Carolina.
Gov. Henry McMaster recently asked federal officials to allow the state to expand Medicaid eligibility for poor parents who are working or going to school.
That’s a step in the right direction, although it doesn’t go far enough.
Some South Carolina lawmakers last year expressed interest in at least exploring the possibility of expanding Medicaid up to 138% of the federal poverty level.
The failed proposal would have been the first serious effort among S.C. lawmakers in at least 10 years to think about the money lost and lives blighted by their misguided refusal to follow the lead of the 40 other states that have expanded Medicaid.
Nationwide, Medicaid provides health care for more than 70 million Americans, including more than 30 million children, 8 million seniors, and 10 million adults with disabilities.
Medicaid also supports more than three of every five nursing home residents.
Cutting Medicaid could severely impact all states, but especially relatively poor and rural states like South Carolina.
Congress and state leaders should heed Trump’s words on Medicaid: Don’t cut it. Strengthen it.