South Carolina

South Carolina health insurance marketplace: history and
news of the state’s exchange

BCBS of South Carolina and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More South Carolina coverage

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    Insurance Guide
    • A guide to health insurance in
      your state.
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    • Your state’s Medicaid expansion,
      eligibilty, contacts
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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

South Carolina exchange overview

In 2018, 198,000 South Carolina residents had enrolled in individual market plans. Of that 198,000, 93% received premium subsidies. Only one carrier offers health insurance for the 2018 year, Blue Cross Blue Shield. In 2017, there were six carriers that offered individual market plans. Average premiums increased by 9.3%. Rates for Blue Cross Blue Shield increased an average of 31%.

South Carolina chose to no expand Medicaid under the Affordable Care Act. In South Carolina, the uninsured rate dropped from 15.8% in 2013 to 10% in 2016. A Kaiser Family Foundation estimated that there are 92,000 residents in the coverage gap. The average premium subsidies were $528 a month.

Health Ratings

South Carolina ranked 41st by the Commonwealth Fund’s Scorecard on State Health System Performance. The state ranked lowest in Prevention & Treatment, Healthy Lives, and Equity. There was emphasis on the number of adults who went without medical or dental care in the past year. Furthermore, America’s Health Rankings placed South Carolina in 44th place. The state faces a few obstacles including the uninsured rates and a fourth of the population is inactive.


South Carolina and Medicaid

Medicaid enrollment in South Carolina has increased by 13% in five years. 224,000 additional residents could be eligible to enroll in Medicaid if the state had chosen to expand. However, the state rules that non-disabled adults without children are ineligible regardless of income and parents with dependent children are only eligible if their household income doesn’t exceed 62% of poverty. In the mean time, South Carolina is focusing on their Healthy Outcomes program. This program helps chronically ill people without insurance get access to treatment via free clinics and hospital charity programs. As of now, the program helps 8,500 people.


Risks in South Carolina

The South Carolina Health Insurance Pool was created in 1989 to give those with a pre-existing medical condition another option. Even after the Affordable Care Act was implemented, the South Carolina Health Insurance Pool is still active.

Medicare Enrollment

Medicare enrollment in South Carolina has reached 941,169 which is about 19% of the state population. 82% of beneficiaries qualify on age whereas the other 18% qualify due to a disability. Medicare pays about $8,675 per enrollee each year. Those who desire some additional benefits can opt for a Medicare Advantage Plan. In South Carolina, 23% of enrollees opt for a Medicare Advantage Plan.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.