Proposed Federal Medicaid Changes Unlikely to Immediately Impact South Carolina

Proposed federal Medicaid changes, including potential work requirements for some recipients, are raising concerns nationally, though health policy experts suggest South Carolinians are unlikely to see immediate effects.

A bill approved by the U.S. House of Representatives contains a provision that would mandate certain Medicaid recipients to meet work requirements to retain their coverage. However, the populations most affected by such a change typically reside in states that have opted to expand their Medicaid programs under the Affordable Care Act. South Carolina is one of ten states that has not expanded its Medicaid program.

A university health policy expert indicated that because South Carolina has not expanded Medicaid, the proposed federal changes do not directly impact the state at this time. The expert advised continued monitoring of the situation.

Despite the lack of immediate applicability, experts suggest that the federal bill, if enacted, could enable South Carolina to adopt similar work requirement rules in the future, particularly if the courts uphold the legality of such provisions. An analyst noted that if courts permit these requirements, states might be more inclined to implement them.

Experience with work requirement programs in other states has shown significant challenges. Arkansas, for example, implemented similar rules in 2018, resulting in approximately 18,000 individuals losing coverage. This loss was not primarily due to unemployment but rather difficulties navigating the state’s reporting system. The expert highlighted that Arkansas spent more on administering the program than on paying medical claims.

Research also indicates that work requirements do not necessarily lead to increased employment. Instead, they often impose an additional burden on individuals already facing hardships.

Should the federal bill become law, states would likely have several years to implement any mandated changes.