Local health care providers are looking for answers in the wake of the U.S.
Supreme Court's decision to uphold the Patient Protection and Affordable Care
While the ruling the allowed much of the law to stand, it also allows states to opt out of expanding Medicaid. And that has some providers worried.
"It makes it impossible to plan. We're talking about a lot of people, so it affects your business. I think the expansion of Medicaid is a more important part of the law than the individual mandate," said Tom Dandridge, president of the Regional Medical Center.
The Medicaid expansion of the Affordable Care Act covers people who earn up to 138 percent of the poverty level. The law also requires Americans to buy health insurance or pay a penalty.
"If a state doesn't expand Medicaid, states will not only not get these newly insured lives, but the working poor are now going to have a heck of a time buying their own insurance," Dandridge said
In addition, hospitals will take a pay reduction, he said. "It's actually going to be a $155 billion cut in reimbursement to hospitals over 10 years. So that's the part that I find troubling."
Leon Brunson, chief executive officer of The Family Health Centers, said he has been praying that the state fully implements the federal law.
"Fourty-two percent of our patients are Medicaid eligible. Medicaid coverage doesn't guarantee that the patients will come to receive health care, but they have a means to pay for it," he said. "If Medicaid coverage is not expanded, we'll be dealing with a large pool of uninsured patients which will end up in the emergency room for primary care.
"What we're trying to do is have every patient a medical home. It's very difficult for us to plan with this sort of uncertainty."
Brunson said he would like to see some citizen forums held around the state to gather input on the law's future.
Dr. Danette McAlhaney, chairperson of the Bamberg County Hospital board, said she is in favor of studying the law and its potential ramifications more. The Bamberg County Hospital closed earlier this year in the face of financial difficulties.
"I know the governor's been trying to be fiscally responsible with the state's money. I wouldn't want to comment at all without having more complete information on both sides. I certainly know when the Bamberg County Hospital was open, we saw a lot patients without insurance," McAlhaney said.
Sen. Brad Hutto, D-Orangeburg, said the issue needs to be studied. "We know from a health perspective that people do much better if they have a medical home. That would obviously be the benefit of having universal health care. The funding from the federal government is South Carolina tax dollars sent to Washington as part of our federal taxes. This is a chance to get this money back in South Carolina," Hutto said.
"Over the next few months, we need to have good policy discussions about who's affected and whether or not we want to participate. The governor's just kind of jumped out there without any knowledge about any of those things. That's all politics," he said.
Sen. John Matthews, D-Bowman, said, "I'm definitely in support of the health care law, and it will help a lot of people in the area I represent and all these counties. I think it would be an economic boon to the health care industry in the rural counties that have a high minority and Medicaid population."
Rep. Gilda Cobb-Hunter, D-Orangeburg, said Medicaid expansion is the simplest most economical way to provide health coverage without overburdening emergency rooms.
"The use of the Medicaid program to provide coverage to families up to 138 percent of poverty will be covered 100 percent by the federal government for the first three years and then 90 percent after that. South Carolina has almost 20 percent of its population without insurance," Cobb-Hunter said.
"In March 2011, the governor's executive order created a group to develop options for South Carolina to opt out of the Affordable Care Act and come up with a plan to cover the uninsured. Since Medicaid expansion has been ruled out, the results of that plan should be made available so the General Assembly can review them," she said.
Cobb-Hunter said the talk about whether the law is a tax versus a penalty is merely a "distraction" from the law being deemed constitutional.
"The tax applies to people who can afford health insurance but choose not to buy it and will affect less than one percent of the population," she said.
Rep. Bakari Sellers, D-Denmark, said, "I think the law is going to save the state tons of money because there's a huge focus on prevention. ...
"This has unfortunately become a political football but in the long run, it's the law and it's been justified. We look forward to its benefits."
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