Issac Bailey

Next on Gov. Nikki Haley’s political-courage list: Expanding Medicaid through ‘Obamacare’

Gov. Nikki Haley
Gov. Nikki Haley

Gov. Nikki Haley has built up an enormous amount of political capital because of the way she handled the Charleston shooting.

Her political star has risen so high so fast, her name is being bandied about again as a potential vice presidential candidate on the 2016 GOP presidential ticket. That’s as it should be; leaders should be recognized when they lead well in difficult times.

It’s time she smartly led the state through another contentious issue. It would be good for South Carolina — and a couple hundred thousand poor residents — if Haley used some of her newfound political capital to secure a long-overdue expansion of Medicaid through the Affordable Care Act.

There’s no longer a good reason to deny the billions in federal dollars that come with the expansion. Other red states, and a few Republican leaders in South Carolina, have already paved the way for Haley and the General Assembly.

The final logical argument against Medicaid expansion was spoiled when the Supreme Court ruled that subsidies for health insurance would remain available for all Americans, even in states that didn’t set up a health care exchange.

Had the court ruled differently, it would have blown a big hole in the ACA, from which no one was sure it would recover.

Before that ruling, there was a bit of uncertainty about the future of health reform, but no longer. Five yearss into the ACA experiment, the dire predictions from critics have been proven wrong or wildly exaggerated.

Health reform is contributing to a decline in the national deficit, not running it up.

Health care premiums have come in below forecast; they have not skyrocketed.

Roughly 16 million people have gained coverage (and millions more have been helped in other ways) instead of millions losing health care access. Gallup has recorded the lowest rate of uninsured Americans it ever has.

Reform has also translated into an estimated 50,000 lives saved annually, including an estimated 200 a year in South Carolina.

The ACA is far from perfect — what man-made program, government or otherwise, isn’t? — but early returns have been better than even supporters expected.

Maybe that’s why S.C. Sen. Ray Cleary, R-Murrells Inlet is pushing for the expansion.

He must know that a study out of the University of South Carolina says the infusion of federal dollars could lead to the creation of more than 40,000 jobs in the state by 2020, help a couple hundred thousand poor South Carolinians gain much needed coverage, and bring down the cost associated with uncompensated care, a problem largely the result of so many uninsured people.

Cleary, a Republican, has co-sponsored the “Financial Responsibility and Opportunity Health Care Program Act,” or Healthy South Carolina.

It would allow South Carolina to follow the lead of other red states, such as Indiana, Kentucky and Arkansas, which have found a way to expand Medicaid on terms best suited to their particular populations.

Under the ACA, the federal government will pick up at least 90 percent of the cost.

“The economic activity created will more than make enough money to pay for the final 10 percent owed,” said Frank Knapp, president and co-founder of the S.C. Small Business Chamber of Commerce. “We are punishing [poor residents] for not making enough money. Other red states, they are rushing towards it now. We want to do it our way? Fine. We definitely need it. It would be great if 194,000 workers had it.”

Haley is navigating her way through a highly-charged “third rail” political issue in the aftermath of what happened in Charleston.

She shouldn’t stop there.

Contact ISSAC BAILEY at or on Twitter @TSN_IssacBailey.