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

Key Findings

  • The new requirement would lead to as many as 5,000 to 14,000 South Carolina parents losing their Medicaid coverage. The policy change would predominantly affect very poor South Carolina mothers. The impact would hit hardest in the state’s small towns and rural communities, where families are more likely to be insured through Medicaid and where jobs are harder to find. African American families would also be disproportionately impacted.
  • Even if these parents find new jobs, they may not be able to afford health coverage provided through their employers, if their employer provides health benefits at all. Only 17 percent of South Carolina non-elderly adults living in poverty receive employer-sponsored insurance. Most are likely to remain uninsured if they lose Medicaid.
  • The loss of coverage for parents would affect their children, exacerbating a troubling surge in the number and rate of uninsured children. South Carolina was one of nine states to see a significant increase in the share of children lacking health coverage in 2017.

[Editor’s Note: On March 4, 2019 South Carolina posted a revised application for state public comment.]


South Carolina officials are proposing that very low-income parents and caregivers who qualify for Medicaid fulfill new reporting requirements to show they are working at least 80 hours a month or participating in job- training activities — or face the loss of their health coverage. The state is seeking a Section 1115 Medicaid 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 new jobs. Or they may lose their coverage as a result of getting tangled up in new reporting requirements.

View the Section 1115 demonstration application.

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