Child Medicaid enrollment in SC dropped 9% after pandemic protections ended
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COLUMBIA — The number of children enrolled in South Carolina’s Medicaid program dropped 9% following the end of a federally mandated pandemic pause on removing people from the government health insurance program.
From May to December of last year, the number of South Carolina children enrolled in Medicaid — through what’s called the Children’s Health Insurance Program — decreased by more than 65,000 to a total of 701,527, according to a study of all 50 states released Thursday by the Center for Children and Families at Georgetown University.
“States have made choices, and these choices are reflected in the data we’re presenting today,” Joan Alker, executive director of the Center, said in a phone call with reporters.
In March of 2020, Congress passed the Families First Coronavirus Response Act. The bipartisan proposal increased Medicaid funding to states in exchange for a commitment not to remove anyone through April 2023. During that three-year period, more than half of the children in the country were covered by the federal-state insurance program for poor families, according to the Georgetown study.
When the congressional pause ended April 1, 2023, those on Medicaid had to renew their benefits or lose coverage, a process known as unwinding.
South Carolina’s Department of Health and Human Services has worked hard over the last year to continue coverage for families who still qualify while removing those no longer eligible, said spokesperson Jeff Leieritz.
The latest numbers from the state’s Medicaid agency are even lower than those in the Georgetown report (which collected data through December): About 657,000 children were enrolled as of last month, Leieritz said. That’s sightly more children than were enrolled before the pandemic.
Children often qualify for Medicaid coverage even when their parents don’t.
In South Carolina, children under 19 qualify if their parents’ income is at or below 213% of the federal poverty level. For a family of four, that’s about $66,000 in annual income. Children with certain disabilities are also eligible regardless of income.
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
When the annual reviews renewed, Leieritz said the department reached out though mailings, text messages, phone calls and emails, as well as checking databases of other agencies that provide government assistance and buying ads on social media and streaming TV services to let people know eligibility checks were resuming.
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.
Historically, the agency has provided health care coverage to about 60% of South Carolina’s children, he said.
Among all ages, Medicaid enrollment increased about 30% during the pandemic, covering 1.34 million South Carolinians as of May 2023. A year later, total enrollment is 1.16 million. That’s about 120,000 more South Carolinians than were covered in February of 2020, according to the agency’s data.
Almost every state saw some drop in enrollment after the unwinding. Nationwide, there were 10% fewer children covered in December, or 4.2 million total.
Numbers ranged from South Dakota, where 28% of its children lost coverage, to a 1% increase in both Hawaii and Rhode Island.
Neighboring Georgia covers 17% fewer children, while North Carolina kept its numbers relatively stable with a drop of just 1%, according to the Georgetown study.
Procedural reasons — such as missing paperwork — are to blame for about 70% of the children who lost their coverage, rather than their parents no longer qualifying, according to Tricia Brooks, a research professor who worked on the report.
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