Wednesday, September 12, 2012

From the House

Bluffton Today

Much of last week was spent in Charleston in Ways and Means and other legislative business meetings. In a prudent measure, we as a committee are seeking to get smarter about the Affordable Care Act, how our state looks to meet the general healthcare challenge, and what our position should be relative to the Healthcare Act.

Currently, South Carolina Medicaid’s monthly enrollment is around 937,000 people. The Department of Health and Human Services projects that very soon our program will top the 1 million mark, which means roughly one in five South Carolinians are Medicaid recipients. We should note that Medicaid pays for about half of the births in our state, as well as a huge portion of the nursing home care received by our disabled and seniors. With the aging of the Baby Boom generation, we see this segment of the program expanding dramatically. As of today, our Medicaid match accounts for 18 percent of our general funds and nearly 25 percent of our total funds.

Despite the virtual avalanche of information on the Affordable Healthcare Act made available as a few paragraphs of the Act came into play, it is still widely seen as a mysterious behemoth. It is 2000 pages of highly specific, densely written legislation with many parts still to be articulated. It was signed into law March 30, 2010, as the largest reform to American healthcare since the passage of Title 119 of the Social Security Act, which created Medicare/Medicaid. It is an expanded coverage. Our state joined with 24 others to challenge the constitutionality of the law, 11 states supported the law, while 12 took no position.

On June 28, the US Supreme Court published its opinion on the Act. The two prevailing findings were that the individual mandate was a tax, and therefore is constitutional, and the federal government cannot withhold Medicaid matching funds if states choose to expand or not.

Where does this leave South Carolina?
Even without expansion, Medicaid in South Carolina will grow by the Act to an additional $160 million. That is $75 million for inflation enrollment for growth, $25 million for eligible but not enrolled resulting from the Act, $52 million from reduced cigarette funding, and $8 million supplement loss of tobacco allocation funds. While mine is only one vote and one opinion, at this juncture, I believe we will say NO to the Affordable Healthcare Act. Having said that, we are about to elect a huge number of federal officials. In addition, the new Congress will be charged with filling in many of the gaps in the current law. Even the repeal of the whole law is not unthinkable if the stars align.

However, as a prudent body, Ways and Means will continue to study and weigh what is best for our citizens, what is best for our state, and ultimately where the future of our nation is headed. But friends, if I were to place a wager on the matter, you probably can guess my inclination. Regardless, check this space in your Wednesday Bluffton Today for periodic updates.

A reminder that tomorrow is the dedication of the Tom Herbkersman Commons, as well as the opening of the new offices of the HHI/ Bluffton Chamber of Commerce offices at the four way stop in Old Town Bluffton. The little pocket park is jewel, with comfortable benches under shade trees, with an interesting mapping feature which says a lot about how we feel about our community. Try to arrive a little before 11 for some refreshments, then brief remarks at 11, followed by BBQ. Tom would have loved it.