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Medicaid Expansion in South Carolina

Dear Colleagues, Friends and Neighbors,

Sometimes it is easier to leave complicated matters to others. Today, however, we are facing a matter that cannot be passed along or ignored.

I am asking you to become informed about the need for Medicaid Expansion in South Carolina. It is a complex – yet fundamental – concern that impacts us, our families, our patients and our state.

The Affordable Care Act (ACA), the federal healthcare reform law, allows states to significantly expand Medicaid health coverage for the poor. But when the U.S. Supreme Court ruled on the ACA last June, it said states couldn't be forced to take the new Medicaid money from the federal government, thereby making it optional.

One important but not very well understood fact is that funding for the ACA will come from significant cuts in payments to hospitals from two federal sources: Medicare and Disproportionate Share (DSH) reductions. For Roper St. Francis, that means millions of dollars in reduced reimbursement. This reduction was intended to be offset by the expansion of coverage for citizens who are currently uninsured who could become eligible under the new definition of Medicaid eligibility. Those cuts will be implemented regardless of whether we expand Medicaid eligibility in South Carolina.

Some elected officials are refusing the billions of dollars the state could use to insure 330,000 of our most vulnerable citizens through Medicaid Expansion. The state’s lawmakers will debate bills about expanding Medicaid and a decision is expected sometime in this legislative session.

The South Carolina Hospital Association (SCHA) is taking the lead on sharing information about the importance of Medicaid Expansion to our patients, and our state’s economy and our industry’s large workforce.

I encourage you visit the Educate Yourself section to watch informative videos about why it is critical that South Carolinians not allow our leaders to opt out of the expansion, a move that would put South Carolina even further behind other states in economic growth and population health.

Let’s stay informed and work together to help influence this decision that will directly impact the vitality of our state's healthcare workforce and its ability to serve those most in need.

Thank you for your interest.


David L. Dunlap
President and CEO
Roper St. Francis Healthcare