Palmetto Project


AHCA – What’s it mean for SC?

medical provider and patientToday the U.S House of Representatives approved legislation that will bring chaos to 20% of the national economy, and cut nearly $1 trillion from existing programs that assist Americans in gaining access to affordable medical care.

Yet, none of South Carolina’s Members of Congress who voted for this legislation seem to know what the impact of the bill will be on South Carolina or how many of the state’s residents will lose health insurance.

This legislation will affect the health insurance premiums and coverage of every South Carolinian.  450,000 working South Carolinians will either lose their health coverage entirely or experience a significant downgrading in coverage coupled with an increase in premiums.  Disabled South Carolinians, along with half of the state’s children, will face similar cuts and new hardships.

Those most in jeopardy are South Carolinians with pre-existing conditions and those who earn modest wages and hold down part-time jobs to make ends meet. Nearly half of the country’s work force will face the prospect of being thrown into “high risk insurance pools” that were proven too expensive for most South Carolinians when the state tried that approach in the past.  AARP says that premiums for those in these pools could reach as high as $25,700 a year.  The bill allows insurers to jack up premiums for older workers (50-64) as much as five times what they are paying now.

The legislation would also repeal requirements that prohibit insurers from discrimination against people with histories of cancer, diabetes, high blood pressure, HIV, cardiovascular disease, asthma, being over 50 or being a woman. It even allows insurers to revert back to discriminating against women who have had a baby or been raped.

No one in Washington seems to know exactly how bad the impact will be or how much it will cost, given the addition of the Upton and MacArthur amendments and the fact that the US Congressional Budget Office (CBO) has not published its report outlining these important facts. Nor is anyone willing to say how many Americans will lose their insurance beyond the CBO’s initial figure of 24 million.

The essence of the bill is a series of tax breaks that disproportionately benefit wealthier taxpayers along with the pharmaceutical and insurance industries. The AHCA substantially decreases financial assistance for low- and middle-income workers, in ways that will cause millions to lose the insurance coverage they have had since 2014.

“Our calculations indicate that the Upton amendment would provide a whole $32.63/year boost to 823,00 South Carolinians with pre-existing conditions who will face higher costs due to pre-existing conditions,” says Steve Skardon, Palmetto Project’s Executive Director. “We’re interested in hearing how Senators Graham and Scott will respond to patients with chronic conditions like asthma, arthritis, and sickle cell, or histories of cancer or heart attack,  whose only coverage options are high-risk insurance pools that are underfunded and proven losers for the vulnerable and sick,” he added.

The AHCA includes:

  • Reductions in tax credits that make coverage affordable for millions of moderate-income families.
  • Higher premiums and out-of-pocket costs, especially for older workers.
  • Those with pre-existing conditions would be forced to pay a hefty penalty for the next year if there is a gap in coverage.
  • Health savings accounts are helpful if you have the extra money.  However, 35% of South Carolina workers are low-income, living paycheck-to-paycheck.  This option does not make healthcare more affordable or accessible to them.

Terri Marsh, 62, from Goose Creek, is very worried about her ACA coverage. She is a full-time caregiver for her grandson who has special healthcare needs and is covered by SC Healthy Connections Medicaid, and her husband, who deals with mobility challenges as a result of multiple sclerosis, and is covered by Medicare. She also has multiple chronic medical conditions that require daily medications and quarterly infusions. She is worried about her ACA coverage. Without the financial assistance offered by the ACA, she would be uninsured, leaving a bleak future for her family. Faced with deteriorating health status, it would make it more difficult for her to adequately care for her husband and grandson. There is no doubt that her husband’s MS symptoms will worsen. It’s the nature of the disease. This certainty will only increase the demand on Terri’s caregiver responsibilities. Without access to her health care providers and medications, this is a nightmare scenario for Terri’s family.

The bill does not have a CBO score which would show the impact of their policies on people’s lives and its cost. Palmetto Project is available for health insurance literacy outreach and education events across South Carolina. Consumers who have general questions can make an appointment with an enrollment specialist by calling 1-888-998-4646, or

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