A South Carolina senator complained that Medicaid health care programs for the poor, elderly and disabled are like a Mercedes Benz as the Senate on Wednesday gave initial approval to a $5.9 billion spending plan.
Wednesday's initial approval with a 24-16 vote sets up lengthy debate that could end with third and final reading later this week.
Spending for the state's Medicaid program has been a top budget issue throughout the debate.
Budget writers balanced the Department of Health and Human Services budget partly by a $125 million reduction in doctor and hospital reimbursements and eliminating a handful of services. Last week, they agreed to require Medicaid patients first to use generic drugs when available instead of brand-name prescriptions.
State Sen. Kevin Bryant, an Anderson Republican, said the state-federal Medicaid program makes people dependent on government and less likely to take jobs that offer worse health care coverage.
"When I look at the coverage offered by Medicaid versus any other health plan, I would compare thatMedicaid coverage to a $100,000 Mercedes," Bryant said. "It's way more than adequate. It's way more than a safety net. It's not a hand up; it's a handout."
Medicaid, Bryant said, "almost forces the recipients to be dependent on the system instead of taking that job that offers coverage that's not quite as good."
But women walking out of Department of Social Services in Columbia into a packed parking lot said legislators deriding the program don't know what they're talking about.
Shawntee Jones, 25, said there aren't enough jobs, particularly offering health insurance. "I believe if they (had) more jobs, people could afford medical care," said the mother of four who is in school studying cosmetology.
"That isn't nothing but a bunch of hogwash" said Jane Alleyne. The 54-year-old was applying for Medicaid after a workplace injury two years ago left her permanently disabled, with no insurance and no prospects of holding down a job. Insurance was offered at her old job and it cost nearly a quarter of her pay.
Tiffany Campbell, 25, works while attending school. But the job doesn't offer insurance and she needs health care for her daughter. The job doesn't pay enough to buy insurance. "I have to use it for her," Campbell said. While there may be problems with Medicaid, Campbell said, "thank God you're getting it."
Medicaid spending has risen as the slow recovery from the recession has increased the number of children eligible for coverage after their parents lost jobs and income. The program is one of the nation's most frugal in terms of benefits offered, said Jeff Stensland, a spokesman for the Department of Health and Human Services.
Other legislators disagreed with Bryant's assessment. "If it's a Mercedes Benz, it's an old one — very old," said Sen. John Matthews, a Bowman Democrat.
Bryant's remarks came as he defended plans that give an unemployment tax break to the South Carolina employers with the worst records for firing people. Bryant said the Senate erred last week by capping the break at $100 million. Bryant argued a bigger break would allow them to hire more people.
The budget debate is grinding into a rare third week. Sen. Tom Davis, a Beaufort Republican, said legislators need to slow down even further.
Davis told senators they must look more closely at overall state spending in the proposed budget for the fiscal year that begins July 1.
Davis noted that general taxpayer fund spending is rising nearly $800 million to $5.9 billion and spending from other state fund sources is up nearly $300 million at $8 billion.
"I can't go back to my district and explain that at a time when households are cutting back — when they're cutting back on expenditures, they're not taking vacations, they're not going out to dinner, they're having to cut back on things — that somehow we couldn't find a way to keep our budget from growing" to $5.9 billion, Davis said.
Davis said the state should plan to use extra cash by returning money to taxpayers or covering things like the state's underfunded retiree and health care benefits.
Senate Finance Committee Chairman Hugh Leatherman, a Florence Republican, said Davis didn't appear to have complaints about spending during the budget debate last week. Leatherman noted Davis didn't offer amendments to curtail spending.
Davis said he offered a spending amendment, but it was ruled out of order. Davis said he'll try to amend the spending plan when it is up for a third and final reading.
Leatherman said the extra spending goes to public schools and colleges, Medicaid and law enforcement — programs that had seen years of deep budget cuts. "I don't know where we get the idea of runaway money," Leatherman said.