Low-Income Families with Children Will Be Harmed by South Carolina’s Proposed Medicaid Work Requirement

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  • Low-Income Families with Children Will Be Harmed by South Carolina’s Proposed Medicaid Work Requirement

In This Report:

Key Findings

  • The proposed work requirement would predominantly affect very poor South Carolina mothers, many of whom are out of the workforce now.
  • Even if these parents find jobs, they may not be able to afford health coverage provided through their employers, if their employers provides health benefits at all.
  • The loss of coverage for parents would affect their children, creating more financial hardship for families and risking children’s access to health care.


South Carolina officials are proposing that parents and caregivers who qualify for Medicaid prove they are working at least 80 hours a month or participating in job-training or volunteer activities before receiving health coverage. The state will have to seek a Section 1115 demonstration waiver from the federal government to implement this plan. If approved, it could mean that many of South Carolina’s poorest parents lose health coverage altogether: They could make too much to qualify for Medicaid but not enough to afford private insurance even if they find jobs. Jobs for low wage workers are unlikely to offer affordable health insurance.

The state estimates that 180,000 parents would be affected by this new policy if the Centers for Medicare and Medicaid Services (CMS) approves the state’s request, according to the draft proposal. About two thirds of those parents also qualify for assistance through SNAP and TANF. While the proposal offers an exemption for those who are primary caregivers, it’s unclear how a primary caregiver would be defined and how many parents would be exempted under the proposal. The draft provides no analysis of how many people would no longer receive Medicaid, but similar proposals in other states show thousands of parents losing coverage. If approved, the work requirement would take effect no later than January 1, 2020.

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