When President Obama met with the nation’s governors in February 2011, S.C. Gov. Nikki Haley asked him to allow states to opt out of key provisions of the Affordable Care Act.
Based on the U.S. Supreme Court’s ruling Thursday, South Carolina no longer has to ask for permission on one provision. State leaders can simply refuse to take part in the law’s expansion of Medicaid benefits in 2014.
The director of the state Health and Human Services agency said Friday his department would favor opting out if it comes down to that.
“I can say pretty directly that as it’s described now in the Affordable Care Act, the administration is not interested at all in pursuing that expansion,” said Tony Keck, who was selected by Haley to lead the Cabinet agency.
Plenty could change before 2014. Republicans in Congress have pledged to repeal or dismantle the Affordable Care Act, and they could have a better chance if fall elections lead to a power shift in Washington.
But if the expansion of Medicaid rolls is still planned in 2014, South Carolina leaders will have a choice. They can accept or reject federal dollars — 100 percent in the first two years, no less than 90 percent after that — to cover an additional 500,000 mostly working poor in the state under Medicaid. Despite the federal government paying most of the cost, Keck thinks the expansion is a bad deal for the state.