An update to the South Carolina Institute of Medicine and Public Health's 2021 report - Health Outcomes Associated with Medicaid Expansion in Adults Reaching Retirement Age

In August 2024, the South Carolina Institute of Medicine and Public Health (IMPH) released its newest report, Health Outcomes Associated with Medicaid Expansion, which is an update to the report released in 2021.

South Carolina has experienced heightened burdens of chronic disease, uncompensated care costs and preventable emergency department visits with chronic disease significantly impacting health outcomes. Heart disease, cancer, stroke, chronic lower respiratory diseases, Alzheimer’s disease, diabetes, chronic liver disease and kidney disease persist as some of the leading causes of death in South Carolina.

In the most recent South Carolina State Health Assessment published in 2024, the top reported health issues include access to care; obesity, nutrition and physical activity; substance use; and mental health. Among the top leading underlying causes of health issues are lack of health care providers, lack of supporting infrastructure to connect people to care, unemployment and lack of health insurance coverage. It is also reported that South Carolina has the sixth highest rate of delayed medical care attributed to cost concerns with uninsured people being the most impacted.

Under the Affordable Care Act (ACA), states have the option to expand Medicaid coverage to all individuals living up to 138% below the federal poverty level (FPL). Generalizable findings suggest that the expansion of public insurance increases health care access and service utilization and subsequently improves health outcomes. A study conducted in 2021 demonstrates an association between Medicaid expansion and improved health behaviors, increased health care service utilization and increased access to health care coverage. It has also been demonstrated that Medicaid beneficiaries under the ACA utilize ambulatory and inpatient care at an increased rate, prescription drugs at a higher rate and health care services at a lower expenditure compared to individuals with private insurance.