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September 6, 2013
Insurance Rolls to Rise in State Fighting Plan
By ROBERT PEAR
FLORENCE, S.C. — Brenda B. Culick has two stents in her heart and a severe wound in her right leg, injured while she was doing home repairs six months ago. But she cannot afford to see a cardiologist or go to a wound care center.
Her household income is $1,200 a month, but she does not qualify for Medicaid because she has no dependent children and is not disabled. Ms. Culick, 52, is one of several hundred thousand people left behind by South Carolina’s refusal to expand Medicaid under President Obama’s health care law — a choice made by about half the states.
“If I could get Medicaid, I’d be the happiest person on earth,” Ms. Culick said.
In her State of the State speech in January, Gov. Nikki R. Haley, a Republican, said, “South Carolina will not implement the public policy disaster that is Obamacare’s Medicaid expansion.” And she boasted of her stance at a recent rally announcing her bid for re-election. “When it came to Obamacare,” she said, “we didn’t just say ‘no,’ we said ‘never.’ ”
The reality, however, is more complex. South Carolina officials say they welcome the prospect that more than a half-million state residents — out of a population of 4.7 million — could soon gain access to affordable coverage, even without the expansion of Medicaid eligibility. And they are working to remake Medicaid so that it does not just pay claims but produces measurable improvements in the health of poor people.
Even without a change in eligibility rules, enrollment is expected to grow as a result of the new health care law. The law requires most Americans to have coverage, and state officials predict that the mandate will prompt more of those who are currently eligible, but not enrolled, to sign up for Medicaid. Consumers will see many advertisements from the Obama administration and insurers urging them to obtain coverage, and that is also expected to drive Medicaid enrollment.
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(Note the governor's "compassionate conservatism" highlighted above.)