aca & medicaid expansion in sc

tonight’s talk

Background Hospital impact Human impact Economic impact Final thoughts

patient protection & affordable care act

On March, 23, 2010, the Patient Protection and Affordable Care Act was signed into law

supreme court Ruled 5-4 on June 28,

2012 to uphold law Individual mandate,

exchanges, insurance rules and other programs still stand

Medicaid expansion is now optional for each state

Subsidies are available to individuals from 100% FPL and above if a state does not opt in

The political question: what will states do?

some background January 1966. Only six states

originally participated when the program launched: Hawaii, Illinois, Minnesota, North Dakota, Oklahoma, Pennsylvania

20 states signed on later that year

11 states joined in 1967 13 more states (southern)

joined in 1968-1972 Arizona last to join in 1982 Eventually all states

participated in basic program and SCHIP (enacted in 1997)

who will benefit?

who isn’t participating?

• 8 states officially not participating

• Primarily southern states including South Carolina

• All but one also not participating in a state-run insurance exchange

state impact on hospitals

the new coverage gap

Families of four making as much as $94,000 a year will receive subsidies to help buy health insurance

Many poor, uninsured South Carolinians would receive no coverage assistance through ACA if SC opts out of the Medicaid expansion Parents in low income families of four making between

$11,500 and $23,000 a year Childless adults making under $11,000 a year 65,000 uninsured citizens age 50-64

the new coverage gap

economic impact in sc

USC economic impact report

SCDHHS estimates $11.2 billion in new federal funding will be generated between 2014 and 2020 due to newly eligible enrollees.

By 2020, the annual economic impact will total $3.3 billion in annual economic output, nearly 44,000 jobs, and approximately $1.5 billion in labor income.

This will translate into additional spending, leading to increases in SC general funds totaling $105.6 million by 2020.

USC economic impact report

This increased tax revenue will completely offset the required state costs over the first seven years and generate a $9 million net surplus.

From 2020 forward after the federal match rate caps at $9 federal to every $1 state, new tax dollars will generate enough to cover 53% of the state required Medicaid match.

how much will the medicaid expansion cost sc?

despite the concerns, these facts remain: SC hospitals will continue to

care for uninsured patients; federal law requires them to do so.

The cost of that care must be paid by someone, and there are two options: We can let the other

states help pay 90% of it (they are offering to do so through Medicaid), or

We can absorb 100% of the costs within our borders.

Which strategy will make SC more competitive?