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SC McDonald’s Employees #GetCovered While at Work

With only a week left before the deadline to sign up for  health insurance  in 2014 without penalties, groups across South Carolina and the nation are hard at work helping families get enrolled in the Affordable Care Act. Specifically, enrolling “young invincibles” in a marketplace plan is critical to the success of the new healthcare system. Here’s the story of one woman’s strategy for reaching young, low-wage workers in rural South Carolina — she meets them where they are.

McDonald EmployyesOver the last several months, Anne Fulcher, a Certified Application Counselor at Rural Health Services Health Center, has enrolled over 150 young adults employed at McDonald’s restaurants near Aiken, SC.

All of those enrolled were under 35 years of age and all qualified for tax credits.  Ms. Fulcher partnered with one of the local McDonald’s franchises and visited all seven of their stores, some more than once, between January and March 2014.   Many of these young adults have never had health insurance and were very excited about the addition of health coverage to  their lives.  Ms. Fulcher experienced similar results at local pawn shops and child care centers.

Worksite enrollment events have proven to be a best practice to reach the young and invincible in South Carolina and Georgia. During the week, most uninsured, low-wage workers are unable to take time off of work to learn about the Affordable Care Act or the coverage options available to them. Or they may not understand how affordable these plans could be for them and their families. Worksite enrollment strategies allow us to reach an audience not captured at other faith-based or community functions.

You can bet Anne Fulcher and her team at Rural Health Services, Inc. will be back at it this week working hard to help more of South Carolina’s uninsured have a chance to sign up for this important coverage.

Another enrollment event will be held on:

Tuesday, March 25, 2014 | McDonald’s
From 2:30 until the last employee who wants to enroll completes the process
1831 Georgia Avenue
North Augusta, SC 29841

 After open enrollment ends, worksite education fairs may prove equally effective to raise awareness about access to affordable health coverage in the Marketplace during special enrollment and open enrollment periods.

Congratulations Rural Health Services, Inc. on this successful best practice to enroll the young and invincible!  For more information, contact Ms. Fulcher at (803) 593-0261 or Gail Diggs, Outreach and Enrollment Coordinator at (803) 380-7013.

Where are the uninsured in South Carolina?

The Coverage Gap

report from the Kaiser Family Foundation predicts roughly 194,000 South Carolinians will fall into a health insurance coverage gap due to incomes above Medicaid eligibility levels, but below poverty limits. They earn too much to qualify for Medicaid, but not enough to qualify for Marketplace premium tax credits. Most of these people have very limited coverage options and are likely to remain uninsured.

Designers of the Affordable Care Act (ACA) relied on states expanding Medicaid as an integral part of the legislation in order to cover individuals under the new health care law. However, when the U.S. Supreme Court ruled expansion optional, some states, like South Carolina, opted out – creating the no man’s land Kaiser and other experts have discovered for South Carolinians and thousands of their fellow citizens across the country. 

Where are our uninsured in South Carolina?

Here are three maps showing where these 194,000 uninsured South Carolinians live…our neighbors, friends, and coworkers who fall into this health insurance coverage gap.

**These maps site the Federal Poverty Guidelines (see table at bottom of page).

The Medicaid Gap in South Carolina

Medicaid Gap by PUMA 2012

Uninsured Non-Elderly Adults | Below 100% Poverty Level

UnInsured aged 19-64 below 100 FPL 2012

Uninsured Non-Elderly Adults | Below 138% Poverty Level

UnInsured aged 19-64 below 138 FPL 2012

[all maps John Ruoff, The Ruoff Group]


Persons in family/household         Poverty guideline
1                                           $11,670
2                                             15,730
3                                             19,790
4                                             23,850
5                                             27,910
6                                             31,970
7                                             36,030
8                                             40,090
**For families/households with more than 8 persons, add $4,060 for each additional person

signupSC | SC Appleseed launches new healthcare Marketplace tool

Sign Up SC logo

signupSC is a website specifically built for providing valuable, credible, and up to date information on the Federal Health Care Marketplace. This site will serve as a resource for individuals, families and advocates in South Carolina to better understand how the Marketplace works.

With 117 days left to enroll in the health exchanges, we hope signupSC will help you better navigate the enrollment process. For those able to purchase health insurance by December 23, 2013 through the Marketplace, affordable, quality health insurance will be available for them starting January 1, 2014 – some for the very first time. While there have been challenges with getting the HealthCare.gov website up and running, there have been significant improvements made to the site and it can now handle more then 50,000 concurrent users. 

signup SC screenshot 2

We understand how critical it is for individuals and families to have access to quality, affordable healthcare. Many South Carolinians are suffering economic hardships and have preexisting medical conditions, previously making healthcare totally out of reach. Inability to afford healthcare can result in further hardship and crippling debt, so SC Appleseed is dedicated to helping those in need understand and access these important benefits.

Through  signupSC, we will:

  •  provide accurate information and helpful links to get enrolled
  • create a central place for you to find basic information about health insurance
  • help you learn how to protect yourself from being scammed
  • debunk the myths surrounding the Affordable Care Act
  • provide information about local resources throughout the state, including times and locations for Navigators (organizations who have been trained to get people enrolled).

signup SC banner

Please share signupSC with others – We can make the Affordable Care Act a success, and through reliable information found on this site, we are one step closer to helping those who are uninsured find coverage.

Kaiser study finds ObamaCare premiums “lower than expected”


The nonpartisan Kaiser Family Foundation, a leading health policy research organization, reported “lower than expected” premiums for ObamaCare’s new insurance exchanges in a major study released last week.

With open enrollment in new insurance marketplaces set to begin Oct. 1, the Foundation compiled premium data from the new marketplaces in the 17 states where it is fully available and released a variety of figures showing how much consumers will pay if they choose to purchase coverage individually.  Last week, they publicly released comprehensive data about their rates and the impact of tax credits that will offset part of the costs for low- and moderate-income families.

The study is among the first to show in detail what a variety of exchange-based health plans will cost people of different ages and incomes under ObamaCare — a major source of debate between supporters and opponents of the law. Kaiser researchers looked specifically at states’ largest cities, plus the District of Columbia, and how much young adults, families of four and older couples will have to pay for nonemployer-based health coverage in those areas.
In Baltimore, for example, a 25-year-old will pay $179 per month for the second lowest cost “silver” plan and $115 per month for the cheapest available option, the lowest cost “bronze” plan. Those monthly premiums drop to $144 and $80, respectively, when researchers assumed that the 25-year-old was eligible for a tax credit based on an income of $25,000 per year.

For a family of four, including two 40-year-old adults, the monthly premium for the second lowest cost “silver” plan would be $683, or $409 with a tax credit based on an income of $60,000. For the lowest cost “bronze” plan, the family would pay $437 monthly or $164 with the tax credit factored in.

Overall, a single 40-year-old who is eligible for ObamaCare’s tax credit could pay a minimum of $97 per month for health coverage in Hartford, Conn., or a maximum of $168 per month in Sioux Falls, S.D.

Researchers with Kaiser wrote that “while premiums will vary significantly across the country, they are generally lower than expected.”

The study did not seek to compare expected premium prices under ObamaCare to current prices on the individual market but stated that 15 of the 18 areas examined had premiums below the level most recently projected by the Congressional Budget Office.

“We estimate that the latest projections from the Congressional Budget Office imply that the premium for a 40-year-old in the second lowest cost silver plan would average $320 per month nationally,” researchers wrote. “Fifteen of the eighteen rating areas we examined have premiums below this level, suggesting that the cost of coverage for consumers and the federal budgetary cost for tax credits will be lower than anticipated.”

ObamaCare requires most people to carry health insurance or face a fine starting in 2014.  While most people receive coverage through their jobs or a federal program like Medicare, some will have to purchase insurance through the new marketplaces, which open for enrollment on Oct. 1. The full premium costs for every state exchange will be available on that date.

This article can be found at TheHill.com

More articles on the Kaiser study:

Obama Administration Launches One-Stop-Shop Website to Educate Business Owners About the Affordable Care Act


WASHINGTON – The Obama Administration today launched Business.USA.gov/healthcare, a one-stop-shop Website which will provide employers of all sizes educational materials on how the Affordable Care Act may affect businesses and help them compete.  The site includes a wizard tool that is tailored based on size and location, so businesses can learn how the law helps them provide affordable coverage options to their employees while still meeting their bottom line.  The site will act as a user-friendly hub that connects employers to informational content on tax credits and other provisions of the law from the Small Business Administration, the Department of Health and Human Services (HHS), and the Treasury Department.

As part of the Administration’s ongoing dialogue with leaders of our nation’s top businesses, this latest tool will help ensure that employers of all sizes know what the Affordable Care Act means for them, and have the information they need to take advantage of the new benefits and opportunities under the law. The Administration will work with the employer community to ensure the site continues to be a helpful resource for businesses and their employees, including updating the site with additional, timely information.

As the Affordable Care Act is implemented, it is so important for us to work with the business community and provide employers with the information they need,” said U.S. Commerce Secretary Penny Pritzker. “The health care website on Business.USA.gov/healthcare will be a tremendous resource for self-employed Americans and businesses of all sizes to learn what the Affordable Care Act means for them.”

“The Affordable Care Act helps level the playing field for small businesses, expanding their bargaining power and their ability to offer the kind of valuable benefit packages that attract and retain top-quality workers. Small businesses are a cornerstone of our economy and we are committed to working with them to raise awareness and access to the historic tax credits that can help small businesses and employees cover the cost of health care,” said Treasury Secretary Jacob J. Lew.

“It’s important for small business owners to know the facts about the Affordable Care Act and Business.USA.gov/healthcare delivers resources and need-to-know information through one streamlined tool,” said SBA Administrator Karen Mills. “This Website will prove to be an invaluable resource for small employers to learn how the law is ushering in better options for them and their employees.”

“The Affordable Care Act is providing better care and better choices for millions of Americans, and this is another great tool for employers to learn how they can offer health coverage that makes sense for their business and employees, and works for their bottom line,” said HHS Secretary Kathleen Sebelius.

Many parts of the Affordable Care Act, which was signed into law in March, 2010, are already in effect, including new consumer protections, and improvements to health care coverage that ensure consumers get more value for their premium dollars.

Additional benefits will take effect in late 2013 and beyond.  Starting October 1, 2013, individuals, including those who are self-employed, and small businesses looking for a better plan, will have a new way to shop for private health insurance through the Health Insurance Marketplace and the Small Business Health Options Program (SHOP) found at HealthCare.gov.   Individuals may be eligible for lower costs on their monthly premiums and self-employed individuals and small businesses may be eligible for tax credits to help with the costs of coverage.

President Obama issued a challenge to government agencies to think beyond their organizational boundaries in the best interest of serving America’s business community, and start thinking and acting more like the businesses they serve. He directed the creation of BusinessUSA.gov, a centralized platform to make it easier than ever for businesses to access services to help them grow and hire.  BusinessUSA.gov leverages the resources of our partners across the federal government to ensure that business owners get comprehensive information and easy-to-use tools related to range of topics, including health care. To learn more, please visit Business.USA.gov.

19 SC Health Centers receive grants from Obama Administration for insurance enrollment assistance

health-insuranceOn July 10, 2013, Health and Human Services (HHS) Secretary Kathleen Sebelius announced $150 million in grant awards to 1,159 health centers across the nation (19 of which are in South Carolina) to enroll uninsured Americans in new health coverage options made available by the Affordable Care Act. With these funds, health centers are expected to hire an additional 2,900 outreach and eligibility assistance workers to assist millions of people nationwide with enrollment into affordable health coverage.

Health centers have a long history of providing eligibility assistance to patients along with delivering high-quality, primary health care services in communities across the nation.  Today, health centers serve more than 21 million patients annually. With these awards, which health centers in all 50 states have received, consumers will get help understanding their coverage options through the new Health Insurance Marketplace, Medicaid and the Children’s Health Insurance Program; determine their eligibility and what financial help they can get; and enroll in new affordable health coverage options.

19 Health Centers Receiving Awards in South Carolina:

Health Center City Award Amount
CARE SOUTH CAROLINA INC Hartsville $208,457
FAMILY HEALTH CENTERS, INC. Orangeburg $124,571
HOPEHEALTH INC Florence $155,899

These awards, issued by the Health Resources and Services Administration (HRSA), complement and aligns with other federal efforts, such as the Centers for Medicare & Medicaid Services-funded Navigator program.

Today’s announcement is part of the administration’s larger effort to make applying for health coverage as easy as possible. The new, consumer-focused HealthCare.gov website and the 24-hour-a-day consumer call center help Americans prepare for open enrollment and ultimately sign up for health coverage.  These new tools will help Americans understand their coverage options and select the plan that best suits their needs when open enrollment in the new Health Insurance Marketplace begins October 1, 2013.

“Health centers are excited to help individuals in their communities  take advantage of the benefits of new health insurance coverage options that start in January, 2014,” said HRSA Administrator Mary Wakefield, Ph.D, R.N. “Having trained, face-to-face assistance in enrollment from trusted resources at local health centers means that more individuals will get the help they need.”

For a list of health centers receiving this funding, visit: http://www.hrsa.gov/about/news/2013tables/outreachandenrollment/.

To learn more about the Affordable Care Act, visit www.HealthCare.gov.  To learn more about HRSA’s Health Center Program, visit http://bphc.hrsa.gov/about/index.html.

The Truth Is…Health Insurance Makes a Difference in Health



As South Carolina’s state Medicaid Director Tony Keck continues to tell state policy makers that expanding the Medicaid program to bring healthcare insurance to the uninsured is not right for SC, we learn from the sound research of the Commonwealth Fund that this is absolutely untrue.

A recent study reported that people who gained insurance coverage through Oregon’s Medicaid program experienced better access to care, increased detection of depression and diabetes, and reduced out-of-pocket costs. Yet blood pressure control, cholesterol levels, and blood sugar levels did not significantly improve. While some have said these findings suggest insurance coverage may not lead to better health, a new post on The Commonwealth Fund Blog argues that previous research leaves little doubt that insurance has a beneficial effect on health status over time. 

Read more about how SC Appleseed will continue to  work hard to ensure the smooth implementation of the Affordable Care Act, and will not forget that Medicaid expansion is the right thing for South Carolina.


Medicaid Expansion in SC – We Continue to Fight


This week, Families USA and the Joint Center for Political and Economic Policies released a study revealing something we have known for quite some time – expanding the Medicaid program as called for in the Affordable Care Act has solid public support. In fact, in polling a broad mix of residents in the five southern states of AL, GA, LA, MS, and SC, they received a 62% favorable response rate. Interestingly, the results from  South Carolinians were the most positive with

65.2% of respondents supporting Medicaid expansion for our state.

A similar poll done by Winthrop University in April 2013 found slightly more than half of South Carolinians say they support Medicaid expansion. 

Yet, despite having the support of most South Carolinians, Governor Nikki Haley and the South Carolina Legislature have resisted the Medicaid Expansion and refused to accept the federal funding for expansion this year.  Simply put, they are out-of-step with their constituents.

Those of us fighting for the expansion understand that not only will broader Medicaid coverage save lives and end unnecessary suffering, it will also stimulate job growth and the economy in our state. Declining the Medicaid expansion now means that even as the Affordable Care Act (ACA) implementation begins, more than 200,000 people in our state will continue to have no health insurance coverage. Here at SC Appleseed, we will continue to fight to close the coverage gap that impacts our working poor.


While we will work hard to ensure the smooth implementation of the Affordable Care Act, we also will not forget that Medicaid expansion is the right thing for South Carolina. We want to thank those Senators who worked so hard this week to include Medicaid expansion in the budget and we hope you will share in our appreciation by contacting the following:
  • Karl B. Allen
  • Paul G. Campbell, Jr.
  • Raymond E. Cleary, III
  • Creighton E. Coleman
  • Robert Ford
  • C. Bradley Hutto
  • Darrell Jackson
  • Kevin L. Johnson
  • Joel Lourie
  • Gerald Malloy
  • John W. Matthews, Jr.
  • J. Thomas McElveen, III
  • J. Yancey McGill
  • Floyd Nicholson
  • Glenn G. Reese
  • John L. Scott, Jr.
  • Nikki G. Setzler
  • Vincent A. Sheheen
  • Kent M. Williams
We are not done. We will be working the rest of this year to make sure this message is heard. We understand that the will of the people is to expand Medicaid to ensure that hardworking, low-income individuals in our state have access to quality healthcare.
The full polling report, “The Deep South and Medicaid Expansion: The View from Alabama, Georgia, Louisiana, Mississippi and South Carolina,” is available at www.jointcenter.org/research/the-deep-south-and-medicaid-expansion

A Simpler Way to Apply for Health Care


The Centers for Medicare & Medicaid Services (CMS) announced Tuesday, April 30, 2013 that the application for health coverage has been simplified and significantly shortened. The application for individuals without health insurance has been reduced from twenty-one to three pages, and the application for families is reduced by two-thirds. The consumer friendly forms are much shorter than industry standards for health insurance applications today.

In addition, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children’s Health Insurance Program (CHIP) and tax credits that will help pay for premiums.

The applications released today, which can be submitted starting on October 1, can be found here: http://cciio.cms.gov/resources/other/index.html#hie

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Expanding Medicaid Will Benefit Both Low-Income Women and Their Babies


For SC Appleseed and our partners in South Carolina, this is yet another example of how accepting the federal dollars for Medicaid support would not only help close gaps in the health coverage, but could be a critical game changer for countless low-income South Carolinians.

According to a study by the Center on Budget and Policy Priority, nearly 6 million women between the ages of 19-44 who do not have insurance could gain health coverage if all states expand their Medicaid programs in 2014 under health reform.

When women have health coverage before becoming pregnant as well as between pregnancies, they are healthier during pregnancy and their babies are more likely to be healthy at birth, research shows. Yet today, millions of low-income women do not have access to continuous health coverage. Instead, under current eligibility rules, many women become eligible for Medicaid only when they become pregnant, and then lose that coverage soon after giving birth.

The Medicaid expansion is therefore a vital opportunity for states to close gaps in the health coverage  of low-income women, many of whom can only gain coverage when they are pregnant under current  eligibility rules. Ensuring continuous coverage would improve the health of women and their babies,  which would lower Medicaid costs related to delivery and postnatal care. Read the full report here.