COLUMBIA, S.C. — Many South Carolinians receiving government health benefits could soon be required to work to retain this coverage.
Gov. Henry McMaster has already directed South Carolina Department of Health and Human Services, which oversees the state’s Medicaid program, to be ready to submit a request as soon as President-elect Donald Trump is inaugurated to enforce a Medicaid work requirement in the state.
“They have to do something other than just stay home or do nothing. That is a very simple requirement. We think it is essential,” McMaster said.
During the first Trump administration, South Carolina had been approved to enforce work requirements for Medicaid recipients.
But they never went into effect because of the COVID-19 pandemic, and the Biden administration has not allowed states to impose these mandates.
“If you have able-bodied adults, able-bodied, they ought to be working if they’re going to receive benefits from the taxes of everybody else,” McMaster said.
If South Carolina’s waiver is approved, this requirement would apply to adults ages 19 to 64 who are not disabled — about 200,000 people right now, according to the Department of Health and Human Services.
It would require them to work at least 80 hours a month or log that same amount of time in job training, taking classes, or volunteering to keep receiving these benefits.
“I always am concerned when we’re adding requirements onto programs. I mean, healthcare is not about work. People need healthcare,” said Sue Berkowitz, policy director for SC Appleseed Legal Justice Center, an organization that advocates for lower-income South Carolinians.
Berkowitz said many Medicaid recipients who can work likely already are or are trying to find a job.
But she fears some could lose their coverage because of administrative burdens or barriers like not having transportation to work.
“Or when we’re at a lower unemployment rate, there may not be jobs available for the people who are actually looking for the work, and what we want to do is make sure that we’re not making it punitive, that we’re really helping people succeed in work,” Berkowitz said.
Under South Carolina’s previously approved waiver, this requirement would not have applied to people living in a region where unemployment was 8% or higher or when the statewide rate was that high.
That was one of around a dozen exemptions under the former request, with the exemptions that will be submitted in this new request still under review, according to the governor’s office.
The following exemptions were included in the previous waiver:
Individuals receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI);
Individuals qualified as Working Disabled;
Primary caregiver of a child, up to age 18, and/or disabled adult;
Individuals identified as medically frail;
Members of federally recognized tribes;
Individuals diagnosed with an acute medical condition that would prevent them from complying with the requirement (as validated by a medical professional);
Individuals who are participating in and exempt from Supplemental Nutrition Assistance Program (SNAP) and/or Temporary Assistance for Needy Families (TANF) employment requirements;
Individuals participating in a Medicaid covered treatment program for alcohol or substance abuse addiction, including opioid addiction;
Individuals who are pregnant or 365 days or less post-partum; and
Individuals residing in regional areas that experience an unemployment rate of 8% or greater or when the statewide unemployment rate is 8% or greater.
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