South Carolina Health Care Exchange Expecting Huge Numbers

Even though South Carolina has spent nothing to advertise the new South Carolina health care exchange, the state is still expecting hundreds of thousands of uninsured residents to flock to the marketplace and enroll in an insurance plan. South Carolina is one of the 36 states that elected to have the federal government run the exchange, which resulted in receiving no grant money for advertising. However, some state organizations are preparing to assist with the enrollment process in the face of a potential flood of enrollees.

The federal government has provided funds to the South Carolina health care exchange to hire navigators who will assist people with the plan comparison and enrollment processes. However, the development of this program appears to still be in the planning stages for this state. Three organizations in South Carolina have received grant money for outreach. These are:

  • DECO Recovery Management LLC – a national leader in patient advocacy and medical assistance eligibility management has received $1,211,203.
  • The Cooperative Ministry – Located in the Columbia-Newberry Region, this organization is creating the Health Insurance Education Cooperative to help inform and enroll residents in that area. This organization received $508,313
  • Beaufort County Black Chamber of Commerce – This organization will be holding community meetings, workshops and individual counseling activities to education residents about the South Carolina insurance marketplace. This organization received $203,099,21

Premiums to Be Higher than National Average

According to a recently released report by the U.S. Department of Health and Human Services, premiums for plans sold on the South Carolina insurance marketplace will be higher than the national average. The weighted average rate across the country for a Silver plan is $310. South Carolina’s rates average $333, which ranks 29th out of the 48 states examined for the report.

The national average for the second-lowest cost Silver plan, which is the plan used to determine federal subsidies, is $328 before tax credits are applied. In South Carolina, the second-lowest cost Silver plan average is $339. The average cost of a Bronze plan on the South Carolina health care exchange will be $267, before subsidies.

Rating Process and Sample Rates

In South Carolina, 46 rating areas were defined based on the number of counties in the state. In every rating area, residents will have at least three insurance companies providing up to 26 qualified health plans from which they can select the best option for their healthcare needs. The maximum number of insurers in any one rating area is four.

Sample rates for a 27-year-old making $25,000 per year in South Carolina would be $223 per month for a 2nd-lowest cost Silver plan before tax credits and $145 per month after federal subsidies were applied. That same 27-year-old would pay $97 per month after tax credits for the cheapest Bronze plan.

Sample rates for a family of four making $50,000 per year in South Carolina would be $809 per month for a second-lowest cost Silver plan before tax credits. This amount would be reduced to $282 per month after federal subsidies were applied. For the lowest-cost Bronze plan, that family would pay $109 per month after tax credits were applied.

You can see all the rates by rating area and age here. Below is a partial screenshot of rates for 40 year old in South Carolina, taken from the previous link:

South Carolina Health Care Exchange Rates

Medicaid Not Expanding

Although there will be premium tax subsidies available to many low-income residents in South Carolina to help them pay for premiums through the South Carolina health care exchange, some very low-income consumers will not be eligible for the subsidies. They may also not qualify for Medicaid because the state has elected not to expand the program.

South Carolina residents are not required to purchase plans on the South Carolina health care exchange. They can purchase plans off exchange, but will not be eligible to receive federal premium subsidies. Residents should be aware of fraudulent attempts to get them to purchase insurance through fake websites. To avoid such scams, they should be accessing the South Carolina health care exchange through healthcare.gov. Open enrollment begins on October 1 and will end on March 31, 2014.