South Carolina health insurance exchange
Strong opposition to ACA from South Carolina leaders, despite nearly one in five residents without insurance
By Louise Norris
December 4, 2013
By the beginning of November, 572 people had finalized their plan selections in the South Carolina exchange, a total that puts the state near the middle of the group of 34 states where HHS is running the exchanges. And more than 3,000 people had qualified for Medicaid or CHIP, despite the fact that South Carolina is not expanding Medicaid and applicants must qualify based on the existing stringent guidelines. HealthCare.gov is working much better at the start of December than it was in October, and the expectation is that thousands of SC residents who began their applications in the early weeks of open enrollment will finalize their plan selections by December 23 – the deadline for a January 1 effective date.
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 gives many people in the existing individual market another alternative to compare with the options available in the exchange.
Given Gov. Nikki 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. In their opposition to the ACA, South Carolina lawmakers even went so far as to try to enact a law (which passed the House but not the Senate) that would have, among other things, granted a state tax deduction in the amount of any penalty that a resident had to pay to the IRS for not complying with the ACA’s individual mandate.
Three companies are offering health insurance through the federally-run marketplace in South Carolina: 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, www.healthcare.gov, 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.
Three federally funded groups have launched training programs and outreach campaigns 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. Their success depends on a fully functioning exchange website though. As of October 27th, the Cooperative Ministry reported that although they have two dozen navigators working to assist people, they had not yet been able to help anyone complete the online enrollment process.
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 /firstname.lastname@example.org