The Crisis in Rural Healthcare
A Policy Briefing for South Carolina Leaders
The Situation at a Glance
South Carolina faces a significant healthcare crisis, with consequences that fall hardest on our rural communities. The data below highlights the scale of the challenge and the urgent need for policy action.
Rural Hospitals Closed
8
Since 2010, representing a critical loss of access for thousands.
South Carolinians Uninsured
497,500
A crisis concentrated in rural areas and low-wage jobs.
Left in Coverage Gap
83,000
Too poor for ACA aid, but ineligible for Healthy Connections.
Core Challenges
Two intertwined issues drive the health crisis: a systemic gap in insurance coverage and the resulting decline of local providers and facilities. Explore the data behind these challenges below.
The Anatomy of the Uninsured Crisis
Statewide, 497,500 South Carolinians lack health insurance. The chart reveals a critical policy failure: 83,000 of these individuals are in the "coverage gap," earning too little for ACA subsidies but deemed ineligible for Healthy Connections Medicaid. This group has no affordable coverage options.
For those with insurance, public programs are essential. Over 1.3 million rely on Healthy Connections, and another 515,000 depend on ACA subsidies to afford their plans. The looming 2025 expiration of enhanced ACA subsidies threatens to move a huge portion of this group into the uninsured category, destabilizing the market and disproportionately harming rural families who have fewer employer-based options.
Actionable Solutions
Addressing this crisis requires decisive, evidence-based policy action. The following proposals represent the most effective strategies to stabilize rural healthcare, improve health outcomes, and ensure economic vitality for communities across the Palmetto State.
The Single Most Impactful Step: Provide additional appropriations to Medicaid and ACA subsidy eligibility to reduce the number of uninsured South Carolinians.
- Economic Benefit: Creates jobs and stimulating local economies.
- Hospital Stability: Provides a critical financial lifeline to struggling rural hospitals by reducing uncompensated care costs, the primary driver of closures.
- Improved Health: Ensures access to preventive care, chronic disease management, and life-saving treatments, leading to a healthier, more productive workforce.