South Carolina Medicaid Overhaul Plan Would Create Personal Health Accounts, Increase Copays

South Carolina Department of Health and Human Services officials last week submitted to CMS for approval a "sweeping" reform plan that would provide beneficiaries with personal health accounts to purchase public or private health coverage, the Charleston Post and Courier reports. The plan, which also would include higher copayments for services, is intended to reduce growth in the state's Medicaid program. Last year, state and federal spending on South Carolina's Medicaid program totaled $4.2 billion, up 50% from 2000. Under the reform plan, South Carolina Medicaid beneficiaries would use personal health accounts to purchase health insurance from the state or private insurers. Insurers would offer a range of coverage, from low-cost plans with limited services to comprehensive HMO plans. Beneficiaries also would receive debit accounts to cover additional out-of-pocket costs and copays, which would range from $5 for a generic prescription drug to $100 for a hospital stay. The amount the state would earmark for each debit account would be similar to the amount state residents spend on private-sector health care and would be based on the beneficiary's age, gender and health status. State HHS Director Robby Kerr said federal officials gave the plan a "favorable initial impression" but added that "[w]e're at the beginning of a very long process" (Maze, Charleston Post and Courier, 6/17).