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South Carolina Health Insurance Exchange

South Carolina uses the federally run health insurance exchange, so people enroll via HealthCare.gov.

Open enrollment for 2021 health plans will start on November 1, 2020, and will continue to December 15, 2020. Before open enrollment, South Carolina persons with qualifying events can still enroll or make changes to their coverage for 2020.

(In previous years, Blue Cross Blue Shield of South Carolina has allowed people to buy plans outside the exchange till the end of December, so for a couple of weeks after open enrollment ends; it is not clear whether they will continue to do this in future years; financial aid is not available outside the exchange).

Blue Cross Blue Shield of South Carolina was the only insurer providing plans in the exchange in 2018, but Ambetter (Absolute Total Care) joined the health insurance exchange in Charleston County for 2019. And for 2020, Molina and Bright Health joined the health insurance exchange marketplace, bringing the total number of insurers to four.

No Medicaid Expansion in South Carolina

US Rep. James Clyburn (D – SC) views the Affordable Care Act as the “Civil Rights Act of the 21st century” and has long called on South Carolina to embrace the law (as well as Medicaid expansion, which SC lawmakers have thus far resisted) and all that it can provide to the state and its residents.

Rep. Clyburn noted that SC ranks 43rd in the United States in terms of overall health, and points out the myriad ways that the ACA can help to improve people’s health.

Additionally, on the 2016 presidential campaign trail, Ohio Governor John Kasich, a contender for the GOP nomination, called on South Carolina to accept federal funding to expand Medicaid.

In large part, because South Carolina failed to expand Medicaid, the uninsured rate in South Carolina is still higher as compared to the national average. According to US Census data, the uninsured residents’ rate was still 10.5 percent in 2018 in South Carolina. That was down from 15.8 percent in 2013, but it was still significantly higher as compared to the 8.9 percent national average as of 2018.

And hospitals in South Carolina, especially those in rural areas of the state, are facing closure due to lack of funding — a problem that hospital administrators believe could be addressed by accepting federal funding to expand Medicaid.

Even though South Carolina has made no progress so far regarding the expansion of Medicaid eligibility, there is one small sliver of good news in the South Carolina Medicaid program: beginning in December 2014, adults covered by Medicaid in South Carolina gained coverage for preventive dental coverage, fillings, and extractions with up to $750 in services available for every member per year.

Grandmothered Health Insurance Plans in South Carolina

The state was quick to accept President Obama’s policy cancellation compromise that permitted health insurance companies to extend existing plans that had been scheduled to terminate at the end of 2013. Also, when HHS extended that proposal in early 2014, South Carolina was once again among the majority of states that chose to allow grandmothered health insurance plans to renew into 2015.

These health insurance plans, described as grandmothered or transitional, are permitted to remain in force until the end of 2021, under the terms of the latest federal extension, issued in 2020. South Carolina has agreed to allow carriers to keep grandmothered plans in force until the end of 2021, at the insurer’s discretion.

It has been left up to every carrier to determine whether they wanted to let their pre-2014 plans continue to be eligible for renewal. This gives many persons — who had individual coverage before 2014 — another chance to compare with the options available in the exchange, but some critics contend that it keeps healthy people out of the new Affordable Care Act-compliant insurance pools.

Resources and References:

• 2018 Health Insurance Coverage in the U.S.
• Grandmothered Plans