Medicaid work requirement endangers the most vulnerable

By Laura Haight

Following through on an idea they first floated in April of 2018, South Carolina officials are proposing a job requirement as a prerequisite for Medicaid.

The proposed rule change would require that clients prove they are working at least 80 hours per month or participating in job-training or volunteer activities. This makes South Carolina one of four states in the country seeking a waiver from the federal government. One state – Kentucky – has been approved.

The rules change would impact an estimated 180,000 of the 1.3 million South Carolinians currently receiving Medicaid. Exempt clients include single parents, two-parent households where one parent is disabled, and those in drug-abuse programs.

An analysis from the Georgetown University Center for Children and Families and the SC Appleseed Legal Justice Center found that the proposed rule would predominantly affect very poor mothers in small towns and rural communities. African-Americans would be disproportionately affected. The trickle-down impact of health coverage loss will severely impact poor children who are already at risk. The report noted that South Carolina was one of nine states that had significant increases in children without health coverage in 2017.

Quoted in the Post and Courier, Sue Berkowitz, executive director of the S.C. Appleseed Legal Justice Center, argues the proposal does not address significant barriers to employment, including transportation, the cost of child care or the scarcity of jobs in rural areas.

What can you do?

Public comment on this proposal, which was released a month ago – in the midst of the holiday season – has been light, according to SC Medicaid Director Joshua Baker. As of the end of December, the state had received only two comments.

Make sure your voice is heard: Submit a comment onlineabout the proposed “Community Engagement” waiver, by visiting

Comments may also be emailed to, or mailed to the South Carolina Department of Health and Human Services, ATTN: Community Engagement Waiver, P.O. Box 8206, Columbia, SC 29202-8206.

A public meeting is planned for Jan. 16 at the Greenville County Public Library, Hughes Main Library, at 6 p.m. Kate Franch, chair of the Greenville County Democratic Party, will be among the speakers.



Be the change you want to see: Help the party with a much-needed donation or volunteer to help!