Topic Paper: Stratification & Health

Key Data on Health and Health Coverage in South Carolina This fact sheet draws on data from “ Health and Health Coverage in the South: A Data Update ” to highlight findings for South Carolina. The findings show the current status of health and health coverage in the state and the potential coverage gains that may be achieved through the A CA. As of 2014, nearly 4.8 million indi viduals lived in South Carolina. South Carolinians account ed for 4% of the total 118 million individuals living in the 17 states , including DC, that make up the American South. People of color make up over one third (3 6%) of South Carolinians. Non -Hispanic Blacks account for a higher share of South Carolina residents compared to the rest of the South and the United States. Over one in four (27%) South Carolinians is Black compared to 19% of Southerners and 12% of the population nationwide (Figure 1) . Figure 1 64% 58% 62% 27% 19% 12% 6% 17% 18% 1% 3% 6% 2% 2% 3% South Carolina South United States Other Asian Hispanic Black White Racial/Ethnic Distribution of the Population, 2014 People of Color36% People of Color38% 4.8 Million 316.2 Million People of Color42% 118.3 Million Notes: Persons of Hispanic origin may be of any race; all other racial/ethnic groups are non -Hispanic. Asian includes Native Ha waiians and Other Pacific Islanders. Other includes American Indians and Alaska Natives and individuals reporting two or more races. Numbers may not sum to 100% due to rounding.Source: Kaiser Family Foundation estimates based on the Census Bureau's March 2015 Current Population Survey (CPS: Annual Social and Economic Supplement). Key Data on Health and Health Coverage in South Carolina 2 Nearly one in five (17%) South Carolinians is poor. The poverty rate in South Carolina is consistent with the Southern region and slightly higher than the overall rate for the U.S. (17% vs. 15%) (Figure 2) . There are significant health needs among South Carolinians. In South Carolina, one in five (20%) adults reports fair or poor health status, over one in ten (1 2%) adults have been told by a doctor they have diabetes, and two -thirds (6 7%) of adults are overweight or obese (Figure 3) . South Carolina also has high infant mortality and cancer death rates compared to rates for the United States (Figure 4). Figure 2 17% 17% 15% South Carolina South United States Percent of Population Below Poverty, 2014 4.8 Million 316.2 Million 118.3 Million Source : Kaiser Family Foundation estimates based on the Census Bureau's March 2015 Current Population Survey (CPS: Annual Social and Economic Supplement ). Figure 4 6.9 6.7 6.0 South Carolina South United States 179.0 171.4 166.4 South Carolina South United States Infant Mortality and Cancer -Related Death Rates Infant Deaths per 1,000 Live Births Cancer -Related Deaths per 100,000 Source: Based on KCMU analysis of Centers for Disease Control (CDC ) Linked Birth/Infant Death Records, 2013 and KCMU analysis of Centers for Disease Control and National Cancer Institute United States Cancer Statistics, 2012 , Incidence and Mortality Web - based Report. Figure 3 20% 12% 67% 20% 11% 66% 18% 11% 64% Fair/Poor Health Status Told by a Doctor Have Diabetes Overweight or Obese South Carolina South United States Source: KCMU analysis of the Center for Disease Control and Prevention (CDC)'s Behavioral Risk Factor Surveillance System (BRFSS) 2014 Survey Results.

Selected Health Indicators Among Adults, 2014 Percent of Adults: Key Data on Health and Health Coverage in South Carolina 3 South Car olinians are more likely to be uninsured compared to the nationwide population. Consistent with the uninsured rate for the Southern region , 15% of nonelderly So uth Carolinians are uninsured, which is higher than the 12% uninsured rate for the nonelderly po pulation nationwide. Uninsured rates are higher for nonelderly adults in South Carolina compared to children (18% vs. 7%). Consistent with adults in the Southern region, nonelderly adults in South Carolina have a higher uninsured rate compared to the overa ll rate for the United States (18% vs. 14%) (Figure 5). Medicaid and CHIP eligibility levels in South Carolina are low compared to the national medians. South Carolina’s Medicaid/CHIP eligibility limit for children is 213% FPL compared to the national median of 255%, and its limit for pregnant women is 199% FPL compared to the national median limit of 205% FPL. Because the state has not adopted the ACA Me dicaid expansion to adults, eligibility for parents remains at just 67% FPL, or about $13,500 for a family of three, and other adults without dependent children remain ineligible regardless of their income (Figure 6). Figure 5 58% 62% 61% 67% 49% 52% 27% 26% 21% 19% 44% 41% 15% 12% 18% 14% 7% 6% South Carolina United States South Carolina United States South Carolina United States Uninsured Medicaid/Other Public Employer/Other Private Health Insurance Coverage of the Nonelderly Population, 2014 Total Nonelderly Nonelderly Adults Children Notes: Private includes employer and non -group coverage. Medicaid includes those covered by Medicaid, the Children's Health Insurance Program, Medicare, military and other public coverage. Data may not sum to 100% due to rounding. Source: Kaiser Family Foundation estimates based on the Census Bureau's March 2015 Current Population Survey (CPS: Annual Social and Economic Supplements). Figure 6 213% 199% 67% 0% 217% 205% 44% 0% 255% 205% 138% 138% Children Pregnant Women Parents Childless Adults South Carolina South United States Median Medicaid/CHIP Eligibility Limits as a Percent of the Federal Poverty Level, January 2016 SOURCE: Based on results from a national survey conducted by KCMU and the Georgetown University Center for Children and Families, January 2016. The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650 -854 -9400 Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202 -347 -5270 www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/KaiserFamFound Filling the need for trusted information on national health issues , the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California . The ACA coverage expansions have the potential to extend health coverage to many uninsured South Carolinians, but because the state has not expanded Medicaid , many poor uninsured adults fall into a coverage gap. Among the 600,000 remaining nonelderly unins ured in South Carolina as of 2015, 17% are eligible for Medicaid and 31% are eligible for tax credit subsidies for Marketplace coverage. However, 20 % or 123,000 fall into a coverage gap (Figure 7). These are poor adults who earn too much to qualify for Med icaid, but not enough to qualify for premium tax credits, which begin at 100% FPL. South Carolinians are more likely to fall into the coverage gap and less likely to be eligible for Medicaid compared to the uninsured nationwide. If South Carolina expanded Medicaid, the coverage gap would be eliminated and 48% of uninsured South Carolinians would be eligible for Medicaid coverage , increasing the total share of uninsured eligible for coverage to 70% (Figure 8). Figure 7 17% 27% 31% 22% 20% 9% 32% 42% South Carolina United States Ineligible For Financial Assistance In the Coverage Gap Eligible for Tax Credits Medicaid Eligible Eligibility for ACA Coverage Among the Nonelderly Uninsured in 2015 Based on Medicaid Expansion Decisions as of January 2016 47% 49% 0.6 Million 32.3 Million Notes: Totals may not sum to 100% due to rounding. Ineligible for Financial Assistance includes those ineligible due to offer ofESI or income and those ineligible due to immigration status. Tax Credit eligible includes adults in MN and NY who are eligible for coverage through the Basic Health Plan.Source: Kaiser Family Foundation analysis based on 2015 Current Population Survey and 2015 Medicaid eligibility levels update d to reflect Medicaid expansion decisions as of January 2016. Figure 8 48% 42% 22% 17% 30% 41% South Carolina United States Ineligible for Financial Assistance Eligible for Tax Credits Medicaid Eligible Eligibility for ACA Coverage Among the Nonelderly Uninsured if All States Expanded Medicaid 70% 59% 0.6 Million 32.3 Million Notes: Totals may not sum to 100% due to rounding. Ineligible for Financial Assistance includes those ineligible due to offer ofESI or income and those ineligible due to immigration status. Tax Credit eligible includes adults in MN and NY who are eligible for coverage through the Basic Health Plan.Source: Kaiser Family Foundation analysis based on 2015 Current Population Survey and 2015 Medicaid eligibility levels update d to assume implementation of the Medicaid expansion in all states.