Columbia, South Carolina – In South Carolina, there was a 9% decrease in the number of children covered by Medicaid after a federal requirement to keep people on the health insurance during the pandemic came to an end. Between May and December of the previous year, the count of children in Medicaid, particularly under the Children’s Health Insurance Program, fell by over 65,000, bringing the total down to 701,527. This information comes from a study by the Center for Children and Families at Georgetown University, which examined Medicaid enrollment across all 50 states and released its findings last Thursday.
“States have made choices, and these choices are reflected in the data we’re presenting today,” said Joan Alker, executive director of the Center.
Back in March 2020, the U.S. Congress had approved the Families First Coronavirus Response Act. This bipartisan act increased the Medicaid funds provided to states on the condition that they would not remove anyone from the program until April 2023. Over this three-year span, the federal-state insurance program, which supports low-income families, covered more than half of the children in the nation, as reported in the Georgetown study
After the federal pause on Medicaid removals ended on April 1, 2023, beneficiaries had to renew their coverage or face losing it, in a process referred to as unwinding. Jeff Leieritz, a spokesperson for South Carolina’s Department of Health and Human Services, explained that over the past year, the department has diligently worked to maintain coverage for those still eligible while discontinuing it for those who are not.
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Recent data from South Carolina’s Medicaid agency shows that about 657,000 children were enrolled in the program as of last month, according to Leieritz. This number is slightly higher than the enrollment figures before the pandemic and lower than the numbers reported in the Georgetown study, which collected data only up to December.
In South Carolina, Medicaid eligibility for children under 19 years old is determined by family income, specifically if it is at or below 213% of the federal poverty level, which equates to around $66,000 annually for a family of four. Additionally, children with certain disabilities qualify for Medicaid regardless of family income.
Leieritz also noted that the department used multiple communication methods to inform people about the resumption of eligibility reviews. These methods included mailings, text messages, phone calls, and emails, along with checking databases from other agencies that provide government assistance. They also invested in social media and streaming TV ads to spread the message.
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The agency also sought and received flexibility from the federal government’s ordinary rules on eligibility checks to smooth the process.
“These efforts, which have included participating in more than 150 community and stakeholder events, have all emphasized maintaining coverage for children,” Leieritz wrote in an email to the SC Daily Gazette.
Leieritz said that historically, around 60% of the state’s children have been covered by Medicaid. During the pandemic, Medicaid enrollment saw a significant rise of approximately 30%, reaching 1.34 million South Carolinians by May 2023. A year later, the total enrollment had dropped to 1.16 million, which is still about 120,000 more than the number of residents covered before the pandemic, in February 2020.
Following the end of the pandemic pause, most states, including South Carolina, experienced a decrease in Medicaid enrollment. By December, there was a 10% reduction in the number of children covered nationwide, totaling 4.2 million. The impact varied by state, with South Dakota seeing a 28% decrease in children covered, while Hawaii and Rhode Island each reported a 1% increase in enrollment. Nearby Georgia saw a 17% reduction in children covered, but North Carolina managed to keep its figures relatively stable, with just a 1% decrease.
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According to Tricia Brooks, a research professor who contributed to the report, procedural issues such as missing paperwork were the reason for approximately 70% of the coverage losses among children, rather than a change in their parents’ eligibility.
In South Carolina, children can be covered by Medicaid if their parents’ income is at or below 213% of the federal poverty level. This year, that cap is:
- $43,537 for a family of two
- $54,996 for a family of three
- $66,456 for a family of four
Parents with a dependent child can also get Medicaid coverage, but their income cap is much lower:
- $12,673 for a family of two
- $16,008 for a family of three
- $19,344 for a family of four
Sources: Healthcare.gov and S.C. Department of Health and Human Services
