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Haley’s Waiting Game On S.C.’s Health Insurance Exchange

From Kaiser Health News:

S.C.’s top health official, Anthony Keck, and Gov. Nikki Haley, not fans of the 2010 health law, are likely to decide to let the federal government run the state’s exchange. (Haley photo by MaryAustinPhoto via Flickr)

By Christopher Weaver

Nov 15, 2011

South Carolina’s top health official will recommend this week that the state decline creating its own health insurance exchange, one of the central tenets of President Barack Obama’s health care law.

Instead, the state should let the federal government build the insurance marketplace in the state for now, Anthony Keck, the director of the state’s Department of Health and Human Services, said in an interview. That recommendation is expected to go to a committee appointed by the governor to study the issue on Friday.

South Carolina, a state dominated by health-law-averse Republicans who got a Tea Party boost in last year’s election, has been heading down this road for months. But the recommendation is the latest step in formalizing objections to the exchange — and it frames the move as pragmatism, even as the state hands over power to the federal government.

The No. 1 reason for the wait-and-see approach? The stakes are so low. If a state does nothing, Washington is required to step in and build an exchange by 2014. That thinking — as well as a list of technical and logistical problems — is swaying decision-makers in other states too, industry analysts say.

State officials say the 2014 deadline is too tight given that rules for the exchanges are not complete, which is one incentive to defer to Washington. Plus, if South Carolina officials don’t like the federally run exchange, they can always circle back and start their own later under rules issued by the federal health department in July.

“What is the first mover advantage for states to rush ahead and implement this, given all the uncertainty?” Keck asked. “States have the safety valve of being able to take it over when they want to.”

“Sometimes, the smartest thing when you’re doing something new like this is to wait,” he said. (more…)

Editorial: Investing In Children’s Health Worthwhile

From The Aiken Standard:

Tony Keck

10/27/2011 11:55 AM

Health and Human Services Director Tony Keck’s has made a request to add $35 million to the agency’s budget next year in an effort to cover 70,000 children under Medicaid. While that seems like an awful lot of money and government healthcare, Keck is correct in stating that this is the “conservative” approach.

Under federal guidelines, these children would need to be added by 2014, and Keck is right that the investment should be done in stages. “We’ve created this mountain we’re going to have to climb,” he said. “You can’t just expect the state budget to go from zero to 60 in one year. You’ve got to start to chip away at that unfunded liability. Let’s next year start to ramp up for whatever happens in 2014.”

Keck is right, but he seems to be looking — perhaps unintentionally — at children as a budget item. Indeed, children are a very precious resource for our state. A multi-million dollar investment in their health may be mandated, but it’s also good policy for our state and state of affairs. Just as education can brings positive results in breaking free of crime and poverty, so too can early health care — in particular preventative care — help to build stronger, better communities, as a new generation of healthy children mature in our state. This ultimately saves South Carolina money in the long-run due to reduced healthcare costs that come with an unhealthy populace.

The oft-cited rhetoric is that they should be taken care of by their parents. We agree. They should be. But many are not. It is true that some parents are derelict in their duty. But the children didn’t pick their parents, and shouldn’t be disenfranchised for that.

Regardless of any of that, the debate whether it should be funded is moot. The fact is, the children need to be covered, and Keck is doing the right thing — even if for budget line reasons — to follow through in a fiscally responsible manner. But the end result will be more covered children. And taking care of children is the conservative approach.

18 S.C. Hospitals To See 8% Cuts To Indigent Care Incentives

From The Post & Courier:

Payment to Roper St. Francis Healthcare’s Bon Secours St. Francis Hospital in West Ashley (left) and East Cooper Medical Center in Mount Pleasant are among the facilities that will see their payments for providing uncompensated care cut by the state.

BY RENEE DUDLEY

rdudley@postandcourier.com

Monday, November 7, 2011

About a third of hospitals serving South Carolinians collected a combined $110 million in state and federal taxpayer money last year through a program designed to reward medical centers that provide high levels of uncompensated care.

But those 18 hospitals actually do not provide a disproportionate amount of care to uninsured South Carolinians and those enrolled in government-sponsored insurance programs.

“Everyone was getting an equal proportion of the money, but that’s not fair to hospitals doing an unequal proportion of work,” said Tony Keck, South Carolina’s Medicaid director.

Now the state is cutting payments to those hospitals by about 8 percent, saving taxpayers nearly $9 million annually.

That hasn’t stopped hospitals facing cuts from crying foul. (more…)

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