If the U.S. Congress ends up passing some kind of national health care reform package and it includes anything resembling a “public option,” you can bet few other states will be as hostile to it as South Carolina.
Forget “You lie!” The Palmetto State may soon become more famous for two different words: “Opt out.”
The idea of allowing individual states to deny their residents access to a public health insurance option is picking up steam in Washington. It comes after a huge push from U.S.
Senate Majority Leader Harry Reid, D-Nevada, and powerful Democratic New York Sen. Chuck Schumer, among others. The senators see the opt-out idea as a way of keeping the public option at least partially alive in the face of near-universal Republican opposition and lukewarm support among conservative Democrats.
South Carolina’s Democratic Congressman and U.S. House Majority Whip James Clyburn of Columbia also believes an opt-out provision could work its way into any final federal health care bill that contains a public option.
“I do believe that most people on our side of the building will not [be opposed to] states opting out,” Clyburn told CNN.
Some conservative leaders believe the opt-out strategy is a ploy Democrats are using as political cover. Regardless, despite South Carolina’s enormous health care needs, many South Carolina lawmakers are likely to do everything they can to fight a public health care options if given the chance to do so at the state level.
“The opt-out would be the worst thing,” says Sue Berkowitz, director of the South Carolina Appleseed Legal Justice Center, a Columbia-based nonprofit that advocates for the low-income community. Berkowitz says lobbyists for private health insurance companies have such a stranglehold on the state legislature that lawmakers would most likely kill any public option.
“We would be so vulnerable to that,” Berkowitz says.
State Rep. Anton Gunn agrees.
“Part of the reason why I’d be very concerned is that we have seen the demonstrated capacity of some of our political leaders in this state to just fight anything that comes from the federal government,” says Gunn, a Democrat who represents parts of Richland and Kershaw counties and served as Barack Obama’s state political director during the presidential campaign. “The General Assembly is generally hostile to proposals and ideas that come from Democrats out of D.C.”
The Palmetto State has indeed featured front-and-center in the national debate over health insurance reform.
In July, South Carolina’s junior senator, Republican Jim DeMint, said that if conservatives could stop Obama’s healthcare reform package it would be Obama’s Waterloo.
“It will break him,” DeMint said.
South Carolina’s senior U.S. senator, Lindsay Graham, also a Republican, has said that a government-run health care plan would be “devastating for this country.”
And, of course, there was U.S. Rep. Joe Wilson’s outburst during a joint session of Congress in September.
Currently, South Carolina ranks 48th in the country in overall health, according to data from the United Health Foundation. The state ranks near the top in such categories as stroke deaths, infant mortality and percentage of uninsured children and near the bottom of such lists as access to prenatal care and percentage of healthy children.
Also, approximately one in six South Carolinians are uninsured, according to Census data, and 80 percent of the uninsured are from working families, according to Families USA. | 
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