SC Governor Awaits Federal Decision on Medicaid Expansion Waiver

State leaders have requested a federal waiver that could change Medicaid coverage for thousands of low-income parents in South Carolina. Governor Henry McMaster has asked the U.S. Department of Health and Human Services (HHS) to approve a Section 1115 waiver, which would allow the state to expand Medicaid coverage with new requirements for eligibility.

The proposed plan would require individuals to work or be enrolled in an approved educational program for at least 80 hours a month to qualify for coverage. This initiative aims to address a gap in coverage for many South Carolinians who earn too much to be eligible for Medicaid but not enough to afford insurance on the federal marketplace.

McMaster has expressed confidence in the proposal, stating that it would strengthen the Medicaid program by promoting independence and self-reliance among the state’s citizens. However, some health policy experts and legal advocates are raising concerns about the feasibility of the work requirements. They suggest that the unpredictable nature of low-wage work could make it difficult for people to meet the hours and accurately report them, potentially causing eligible individuals to lose their benefits.

Advocates also argue that imposing such requirements could create more harm than good, questioning the barriers placed on individuals seeking healthcare. They suggest that a full Medicaid expansion without such requirements would be more effective.

Despite these concerns, experts point to studies showing that health insurance coverage can lead to significant improvements in mental health and offer substantial financial protection. The federal government is currently reviewing the waiver, and a decision is expected to take several months.