We can do better for S.C.'s health care


For the past several months, I've listened as Congress debated the future of America's health care system, from the American Health Care Act passed by the U.S. House of Representatives in May to the Better Care Reconciliation Act that now stands before the U.S. Senate. And I must say that from the perspective of a health care provider, this proposal is not good for South Carolina.

The most recent analysis from the Congressional Budget Office projects that the BCRA would cause 22 million Americans to lose access to health coverage and dramatically increase out-of-pocket spending, particularly for older citizens. This is not only because the BCRA would increase the amount of cost sharing for health insurance for many Americans, but also because it would allow insurers to charge older adults aged 50-64 more money for their health insurance. This would make health insurance too expensive for this population and force many of the state's vulnerable elderly to drop their health coverage.

The BCRA would also drastically reduce the amount of Medicaid funding relied on by South Carolina's poor, elderly and disabled citizens. Because South Carolina has a large number of low-income citizens and an overall poor status of health, our state has been identified as one of the states that would suffer the most under the Medicaid cuts proposed by the BCRA. And by cutting Medicaid funding, South Carolina would virtually lock in these health disparities for years to come. Even if dire economic times forced more South Carolinians onto the Medicaid rolls, we would have less support from the federal government to help those vulnerable citizens. If a public health outbreak like Zika were to hit South Carolina, we would not have the federal resources to address a major increase in utilization within the Medicaid population.

South Carolina is home to roughly 4.9 million people, and 1.2 million of those citizens rely on Medicaid as their safety net for access to care. That's one quarter of the state's population, and many of them are children. Based on their income and circumstances, there simply isn't another viable option for them to access affordable health coverage. And of the approximately 115,000 people who call Sumter County home, almost 35,000 of our neighbors, family and colleagues depend on Medicaid for health care access. That's roughly one third of the county. South Carolina, and especially Sumter County, simply can't afford to see Medicaid reduced for our friends and loved ones.

Meanwhile, states like Massachusetts and New Jersey would continue to spend significantly more on their Medicaid beneficiaries and lock in enhanced funding subsidized by the taxpayers here in South Carolina. In fact, a recent analysis commissioned by the Texas and Missouri hospital associations found that the 19 conservative states like South Carolina that stood up to Obamacare's Medicaid expansion will have foregone an additional $737 billion in federal Medicaid expenditures compared to states that opted to expand the program. It just doesn't make sense to me that the states that were steadfast in their opposition to Obamacare will now be disadvantaged by a proposal that ultimately hurts our hospitals and the patients and communities we serve.

As someone with decades of experience in health care, who has served in various roles from nursing supervisor to the board room, I recognize that Obamacare has its flaws, and I stand ready to work with Sens. Lindsey Graham and Tim Scott to make it better. However, the BCRA currently proposed in the Senate will not make things better for South Carolina. It will make things worse for my state, my community and my hospital.

Terrie Carlton is the nurse executive for Palmetto Health Tuomey. She is a board-certified registered nurse with a master's in nursing. She's also a licensed nursing home administrator for the state of South Carolina. Terrie has been at Tuomey for 26 years, starting as a bedside nurse on the medical-surgical unit. She was recently named a Woman of Impact for the Palmetto Health system.