April 17, 2013

The board of directors of the Greater Pickens Chamber of Commerce took a bold stand last week supporting responsible expansion of Medicaid.

The board did so by writing a letter, the message of which it hopes will ultimately find its way to state officials deciding about the Medicaid option presented in recent months. So far the General Assembly and Gov. Nikki Haley have opposed accepting $4.1 billion in federal assistance over three years.

The whole idea of expanding Medicaid funding to more South Carolinians comes as part of President Barack Obama’s Affordable Care plan. Under a U.S. Supreme Court ruling, states have the right to accept or reject the offer of federal aid that will pay for more health care for indigent and handicapped South Carolinians.

The action will be seen by many as supporting ObamaCare when in fact the board used sound business reasoning to support economic growth of the state.

Under the plan, South Carolina can receive the funding to help expand health services to indigent and handicapped people in the state. After three years the state would take on responsibility for matching a portion of the proceeds. By 2020 South Carolina, under the current plan would have to contribute 10 percent of the shared dollars to receive the federal portion.

Some leaders are concerned they don’t know how much the final price tag will be for taxpayers in part because they don’t know how many people will join Medicaid roles who are not currently receiving aid. Estimates range from 250,000 people to 600,000 people.

Despite the actual number — and we believe it will fall somewhere in between the two extremes – the federal government will pay the cost for three years, under the plan. Then the state will need to pay only 10 percent of the cost in and after 2020.

One could argue – and many have – that the federal government is in no position financially to take on such a burden. The federal budget deficit is far from acceptable, but we as a nation are paying much of the cost of indigent care anyway through cost shifting. If someone who can’t pay for medical help goes to an emergency room, the rest of us you can pay do pay. The president’s plan just owns up to this fact and looks for a way to pay responsibly and tell everyone where the costs are coming from.

The Medicaid expansion will provide dollars for people to be treated at clinics and doctor’s offices accepting Medicaid. All those people getting health care will need someone to provide that health care. That means healthcare jobs for South Carolinians. Healthcare workers buy cars and houses and groceries and shoes, so people who sell those things should see advantage.

There are many what-ifs in this equation, many unknowns.

It is fairly easy to see, however, that if South Carolina ends up being the state that does not accept the federal aid, it will be the one paying more for health care per employee, per company. That is bad for business.

The Pickens Chamber took a bold and dangerous political step, but there is considerable reason to believe it is the right one for South Carolina.