Medicaid, Obamacare enrollment up in SC as many lost employer health care during pandemic

MM Curator summary


South Carolina has added 90,000 members to its Medicaid rolls during the pandemic so far.


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More people in South Carolina are relying on government safety-net programs for health insurance as the economic effects of COVID-19 linger.

Enrollment in both Medicaid, the state-run health insurance program for low-income people, and the Affordable Care Act, which provides government subsidies to almost everyone who signs up, were up by tens of thousands as 2020 drew to a close. 

Experts believe the uptick is directly tied to people losing their jobs during the pandemic or deciding to leave the workforce because of COVID-19′s effects. 

Between March and December, 90,000 people were added to the state’s Medicaid program. And though Medicaid covers mostly children in South Carolina, the majority of additions to the program were adults. 

Meanwhile, South Carolina dropped roughly 76,000 people from its labor force between February and December.

Laura Ullrich, an economist at the Federal Reserve Bank of Richmond, said there is no doubt those two facts are linked. 


Though South Carolina’s 4.6 percent unemployment rate looks good on its face, Ullrich said the figure does not account for people leaving the workforce. 

The S.C. Department of Health and Human Services, which operates the state Medicaid program, says the new enrollees should not cause a strain on funding. 

About 70 percent of the funding that fuels the South Carolina Medicaid program comes from the federal government, according to the state agency. During the pandemic, states received a boost in that funding for the duration of the public health emergency. A spokesman said the agency also has held onto a reserve fund since the Great Recession in order to prepare for downturns like the one COVID-19 brought. 

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Also, because Medicaid’s rules changed during the pandemic, it’s not kicking people off their coverage who might not qualify anymore. That lower churn has meant more people are staying on the program.

Still, the threshold to qualify for Medicaid as an adult is high. And even before the pandemic, 16 percent of South Carolina adults younger than 65 lacked any health coverage — one of the highest rates in the country — according to the Kaiser Family Foundation.

In another indicator of people’s need for health coverage, 16,000 more South Carolinians selected plans on during open enrollment in 2020 than 2019. It was the highest level of enrollment seen since 2016, the third year of the program. 

Shelli Quenga, director of programs for the nonprofit insurance agency The Palmetto Project, has been helping people enroll in the plans through the Affordable Care Act since 2013.


Open enrollment on typically lasts six weeks. But because of the pandemic, newly inaugurated President Joe Biden decided to reopen the sign-up period. It will remain open until mid-May.

Quenga said her organization’s call center has been surprisingly busy. “We have been slammed with people trying really hard to get coverage,” she said. 

Another 6,100 people have signed up during the extension in South Carolina so far. With the government aid, some people can even qualify for high-deductible health plans that cost $0 a month. 

Quenga said there are still many people in South Carolina whose income is too high for Medicaid, yet they don’t make enough money to qualify for help through the Affordable Care Act, either. They fall into what’s known as the “coverage gap.”

“There’s that chasm that families can fall into,” she said. “You’re just out there, hanging in the wind, hoping that you don’t get sick.”

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