Berkowitz was already working in health advocacy, but after her experience with her don, she became even more invested in her health advocacy and legal work in South Carolina. She worked to get votes from South Carolina to help pass the Affordable Care Act in 2010, which prohibits insurers from denying coverage due to a preexisting condition. Berkowitz cried as she watched the bill pass.
South Carolina is one of 12 states that has not expanded Medicaid to cover those living under 138% of the poverty level. It also has the second-highest level of people with medical debt in the country, at 22% — nearly double the national rate, according to data from the Urban Institute. Without Medicaid, the options for care are limited. Many people end up in emergency rooms for non-urgent care needs that could be covered by a primary care provider, Giannouchos said. His research found rates of people going to emergency rooms for non-urgent medical problems is significantly less in states that have expanded Medicaid.
Foley sees the need for more coverage. Many patients with chronic illness often end up with medical debt that could have been avoided with coverage, she said. Those with medical debt can have their wages or tax return garnished, Berkowitz said. A bill to stop health care providers from pursuing collections of medical debt or reporting the debt to credit agencies failed in the South Carolina House in 2021.
Berkowitz hopes expanding Medicaid would benefit hospitals as well as patients, as patients who previously could not pay would gain coverage, she said. An estimated 350,000 more people would be eligible for Medicaid under expansion, according to the Urban Institute. It’s estimated the number of uninsured people in South Carolina could decrease by about 37%, the Urban Institute found.Expansion has not been passed by the Republican-controlled government because of politics, Berkowitz said.