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Outrage After South Carolina Gets Trump OK to Attack Medicaid With Work Requirement Policy

Instead of addressing the "alarming increase in the number of uninsured children across the country," the state chose to put up "more barriers to coverage that will worsen this trend."

A small group of activists rally against the Republican healthcare agenda outside of the Metropolitan Republican Club, July 5, 2017 in New York City

A small group of activists rally against the Republican healthcare agenda outside of the Metropolitan Republican Club, July 5, 2017 in New York City. (Photo: Drew Angerer/Getty Images)

Medical groups, anti-poverty advocates, and progressive voices condemned South Carolina's Republican Gov. Henry McMaster announcement Thursday that the Trump administration has approved the state's request to impose work requirements on Medicaid recipients—a move that threatens the healthcare of thousands.

"South Carolinians deserve better than this," said American Federation of Teachers president Randi Weingarten.

McMaster made the announcement alongside the state Department of Health and Human Services Director Joshua D. Baker and President Donald Trump's Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, who helped design Indiana's "punitive" Medicaid system under then-Governor Mike Pence.   

A press statement from the governor's office charges that the move will "incentivize able bodied adults to gain financial independence through 80 hours of monthly work, job training, education, or community service," but critics of the move like Joan Alker, executive director of the Georgetown Center for Children and Families, say it "directly targets the poorest families and kids."

Gov. McMaster requested approval of the work requirements back in January 2018, several months after Verma had encouraged states to pursue so-called "flexibility" in their Medicaid programs and announced specifically that she encouraged the use of work requirements for Medicaid recipients. 

South Carolina now becomes the 10th state to impose the requirement, though three of them—Arkansas, Kentucky, and New Hampshire—have seen their laws struck down by a federal judge.

"South Carolina is one of a few remaining states that has not expanded Medicaid eligibility to more adults under the Affordable Care Act. Here, adults without children rarely qualify for coverage, no matter their poverty level," the Post and Courier noted.

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In its own application for the requirements, South Carolina said that 7,100 parents would lose coverage.

In a joint statement issued Thursday, prominent medical groups and children's health groups including the American Academy of Pediatrics, Children's Defense Fund, Georgetown University Center for Children and Families, and the March of Dimes said, "With this approval, South Carolina becomes the first state in the nation to exclusively impose the harmful policy of work requirements on low-income parents with children."

With research out earlier this year backing up their claim, the groups said, "Medicaid work reporting requirements just don't work."

"The requirements are burdensome for individuals, do not lead to increases in employment, and instead cause people to lose their health insurance coverage," the groups added. Countering McMaster's and the Trump administration's assertions, the groups said that the "Medicaid waiver does nothing to help parents living in or near poverty to overcome the barriers they face in obtaining jobs, such as providing affordable, quality childcare and job training, but instead adds red tape burdens that will fall squarely on parents' shoulders."

A better step for the state to have taken, the groups said, would have been to address the "alarming increase in the number of uninsured children across the country" rather than "allowing more barriers to coverage that will worsen this trend."

The threat of the loss of essential healthcare coverage comes just as many are celebrating holidays.

"In this season of peace and good will to humanity, we must stand with the law, our families, communities, and state," said the South Carolina Appleseed Legal Justice Cente.

"Instead of stubbornly pursuing failed and illegal work requirements, we must expand Medicaid, an essential support for healthcare stability for both individuals and entire healthcare systems," the justice group continued.  "Until we abandon efforts to criminalize, pester, and punish the less fortunate, we will not solve South Carolina's biggest problems."

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