SC Gov. McMaster takes on Biden after he pulls back on Trump’s Medicaid work approval

Gov. Henry McMaster and the South Carolina Department of Health and Human Services Tuesday denounced a Biden administration move to prevent the state from inputting work requirements for certain people on Medicaid.

In 2019, South Carolina got approval from the Trump administration to implement work or community service requirements for Medicaid recipients. South Carolina’s plan to implement the work requirements had been delayed until January 2022 because of the ongoing pandemic.

But the federal Department of Health and Human Services reversed those requirements in August. South Carolina, through its Healthy Connections Community Engagement Initiative, planned to have people on Medicaid to work at least 80 hours a month or do other activities such as look for a job or volunteer.

“In light of the ongoing disruptions caused by the COVID-19 pandemic, South Carolina’s community engagement requirement risks significant coverage losses and harm to beneficiaries,” the Centers for Medicare and Medicaid Services wrote to South Carolina in August.

About 1.2 million people in South Carolina are on Medicaid. Most of them are children, disabled and elderly people. South Carolina’s work requirement excluded people who serve as the primary caregiver of a child or someone who is disabled, pregnant, disabled individuals and people ages 65 and older.

“CMS’ decision to withdraw the authorities used to support this initiative not only stifles innovation in coverage design, it also rejects the precedent that states should promote fiscal sustainability and healthy behavior set by a bipartisan group of CMS leadership,” Director Robert Kerr wrote in a letter to CMS.

Kerr added the state has a surplus of job openings and a low labor force participation rate.

“The Healthy Connections Community Engagement Initiative encouraged financial independence by incentivizing adult South Carolinians without a qualifying exemption to work, participate in an education or work training program or serve their communities, and raised the income cap for Medicaid eligibility for low-income South Carolinians who completed a qualifying activity,” the news release said.

McMaster, who also has been against expanding Medicaid in South Carolina even with expanded federal subsidies, has said having people work is the best way out of poverty.

“Rather than incentivizing able-bodied young adults to find one of the tens of thousands of jobs available in South Carolina, the Biden Administration has decided to double down on paying them to stay at home,” McMaster said. “In a time when our state’s economy is strong and we have employers looking for qualified employees, there’s no reason we shouldn’t have the ability to require our people to find a job, participate in workforce training, or serve in their communities as a condition of receiving taxpayer-funded health care.”

Sue Berkowitz, the director of the South Carolina Appleseed Legal Justice, applauded the Biden administration’s move to remove the work requirements.

“The whole point of Medicaid is not to make it a work program, but it is a health insurance program,” Berkowitz said. “We do know when people have quality affordable health care, they are in a better position to find themselves employment.”

Berkowitz said people on tying someone having a job being healthier is a “stretch.”

“I wish (McMaster) would talk to people who are going without health insurance right now and who are struggling to have living wage jobs,” Berkowitz said. “Maybe if he had those conversations with the real people of South Carolina and understood the struggles they are going through, he might rethink about how to develop these policies and what’s in the best interest of the people of our state.”