south-carolina guide to health insurance

Or call toll-free

South Carolina health insurance exchange

87% of enrollees in SC subsidized; 28k enroll in Medicaid

Share this:

Enrollment – triggered by qualifying events – has continued to grow in the South Carolina exchange since April, but an updated report from HHS won’t be out until November, when the 2015 open enrollment is scheduled to begin.  HHS released a report in June detailing average after-subsidy premiums in the federally facilitate marketplaces, and South Carolina is very much in line with the national averages:  87% of enrollees in the SC exchange received a subsidy, the same as the overall percentage across the 36 HHS-run exchanges.  And the average after-subsidy premium in SC is $84, just two dollars higher than the average across all 36 states.

By April 19, 118,324 South Carolina residents had completed their private plan Obamacare enrollments in the exchange, including those who enrolled after March 31 because of a qualifying event, or through the extension that HHS granted to people who started their applications by the end of March.  This total is more than double the enrollment total as of March 1.  In addition, 28,359 exchange applicants had enrolled in Medicaid, qualifying under the state’s existing guidelines (South Carolina has not expanded Medicaid under the ACA).

South Carolina is among the 18 states where the “employee choice” feature of the SHOP exchange has been delayed another year – from 2015 until 2016.  This benefit will eventually allow employees to select from among a broad range of plans selected by the employer, but until 2016, there will be only one plan available for employees to select.

US Rep. James Clyburn (D – SC) views the ACA as the “Civil Rights Act of the 21st century” and is calling on South Carolina to embrace the law (including Medicaid expansion, which SC lawmakers have thus far resisted) and all that it can offer to the state and its residents.  In his article, Rep. Clyburn notes that SC ranks 43rd in the US in terms of overall health, and points out the myriad ways that the ACA can help to improve residents’ health.

But despite the fact that nearly 20% of the population in South Carolina is uninsured, the state made headlines in 2014 thanks to anti-ACA legislation.  They started with a bill that would have effectively prohibited the implementation of the the ACA in the state.  The curiously-named South Carolina Freedom of Health Care Protection Act (H3101) would have blocked state employees from participating in the exchange and would have reimbursed residents facing an IRS penalty for not complying with the ACA’s individual mandate.  The bill passed the SC House last spring, and Governor Nikki Haley supports the legislation.  However, it failed a second reading in the Senate on March 19.  Republican lawmakers in SC aren’t giving up on their efforts to nullify the ACA though – Senate Republican Tom Davis introduced an amendment to the bill in early March in an effort to continue to fight against the law in a state that desperately needs the ACA.  But in early May, the SC Senate voted 23 – 19 to table the amendment.  Davis believes that Senate Republicans (with a majority) “didn’t deliver“, but uninsured and underinsured South Carolina residents probably see things a little differently.


South Carolina was quick to accept President Obama’s policy cancellation compromise that allows carriers to extend existing plans that had been scheduled to terminate at the end of the year.  Carriers have the option of whether or not to move forward with renewing the policies, and by December 3 two SC Blues carriers had opted to do so.  This gave many people in the existing individual market another alternative to compare with the options available in the exchange.

Given Gov. Haley’s outspoken opposition to the Affordable Care Act, it is no surprise that the federal government is running the health insurance marketplace in South Carolina. Haley announced her decision in November 2012.

Four companies are offering health insurance through the federally-run marketplace in South Carolina:Blue Choice Health Plan, Blue Cross Blue Shield of South Carolina, Consumers’ Choice Health Plan and Coventry Health Care of the Carolinas. In total, 52 options, with varying premiums and deductibles are available for individuals and families. A preliminary report released by the U.S. Department of Health and Human Services (HHS) found premiums in South Carolina to be higher than the national average. In South Carolina, the average cost for the least-expensive bronze plan is $267 a month before tax credits or subsidies. The national average for the lowest cost bronze plans is $249 a month.  The federal mareketplace website,, shows all of the options available, although it has struggled during its first month of operation to work out glitches and create a smooth enrollment process.

Rates for 2015 don’t have to be filed in South Carolina until September, so consumers won’t know how much premiums will increase until the fall.  Across the country, 2015 rates that have been filed so far have followed a general pattern of increases (although there have been some decreases), but the increases have not been as sharp as they’ve been in past years.  The South Carolina Department of Insurance expects all four carriers to remain in the exchange in 2015, but there is no word yet on rate changes for next year.

Three federally funded groups launched training programs and outreach campaigns in 2013 to help consumers understand their options. DECO Recovery Management, Cooperative Ministry, and the Beaufort County Black Chamber of Commerce all received grants to hire “navigators.” Navigators provide unbiased information about the options available through the marketplace and help consumers through the enrollment process, but cannot be directly or indirectly paid by insurance companies.

South Carolina was among the states that received the least amount of federal funding in the initial planning grants – the state got $1 million.  This is a thousand times less than the $1 billion that California received (and several other states got hundreds of millions), but is predicated on the state’s refusal to promote the ACA – the money wouldn’t have been utilized by the South Carolina government.

According to the HHS, more than 750,000 – about 19.4% of the population – South Carolina residents are uninsured and eligible to use the new marketplace.  This is higher than the national average rate of uninsureds (17.3%) and makes South Carolina one of the states most in need of healthcare reform, exchange subsidies and Medicaid expansion.  Unfortunately, South Carolina is not expanding Medicaid, which leaves many low-income residents in a “coverage gap” where they earn too little money to qualify for exchange subsidies, but do not qualify for Medicaid based on existing eligibility rules.

South Carolina health insurance exchange links

State Exchange Profile: South Carolina
The Henry J. Kaiser Family Foundation overview of South Carolina’s progress toward creating a state health insurance exchange.

South Carolina Consumer Assistance Program
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(800) 768-3467  /