News Summary
South Carolina is on the brink of a health insurance crisis as rising premiums under the Affordable Care Act may push over 150,000 residents to drop their coverage. With the expiration of enhanced federal subsidies and ongoing debates in Congress, the projected 231% spike in ACA rates could financially strain many families. As the open enrollment period nears, urgency grows for lawmakers to reinstate these crucial subsidies to protect vulnerable populations from losing their healthcare access.
South Carolina is facing a looming health insurance crisis as rising premiums under the Affordable Care Act (ACA) may force over 150,000 residents to drop their coverage due to a potential government shutdown. The ACA is vital for more than 600,000 South Carolinians who rely on it for affordable health insurance, especially as Congress debates the restoration of enhanced federal subsidies that were recently ended.
The enhanced healthcare subsidies, originally instituted during the COVID-19 pandemic, have enabled 24 million middle- and lower-income Americans to afford private health insurance plans under the ACA. However, since the federal shutdown began on October 1, Congressional Democrats have resisted any plan to reopen the government that does not include reinstating these important subsidies, which were eliminated by recent legislation proposed by GOP lawmakers.
The implications of these changes are severe. Under the proposed GOP plan, a typical family of four making $90,000 a year could see an increase in their annual healthcare costs by $3,735, or more than $300 a month. This substantial increase in financial burden could lead many families to reconsider their health insurance options and potentially abandon their plans.
The S.C. Hospital Association has projected that with rising ACA rates, approximately 150,000 South Carolinians may find it financially impossible to maintain their health insurance. The Palmetto Project anticipates that premium prices could jump anywhere from 11% to an alarming 231% for individuals earning median income or less, placing further strain on the state’s vulnerable populations.
As the situation unfolds, the urgency for intervention becomes particularly pressing. The open enrollment period for 2024 ACA plans begins on November 1, and advocates are calling for the reinstatement of subsidies to alleviate the impending crisis. With only 21% of small business owners in South Carolina being able to afford to provide health insurance, the rising ACA rates could significantly cut the number of individuals who have access to healthcare.
U.S. economist Joseph Von Nessen has warned about potential economic ramifications if the government shutdown continues beyond 30 days, including the risk of disrupted federal contracts and missed paychecks for federal employees. Furthermore, the number of uninsured individuals in South Carolina could increase by 2% if proposed Medicaid cuts and the expiration of ACA subsidies proceed without intervention.
For many individuals already struggling to afford health insurance, the anticipated premium increases could lead to severe health consequences. If subsidies expire, approximately 99,000 people in South Carolina may lose their healthcare coverage entirely, according to estimates by the Kaiser Family Foundation. In the context of a broader economic downturn related to the federal shutdown, the situation could further drive individuals toward emergency medical care as rising costs make preventive care unattainable.
The legislative conversations surrounding the ACA suggest a struggle between the essential need to secure healthcare access for the most vulnerable and concerns about fraud and the integrity of eligibility verification processes in health care programs. As South Carolina’s residents and lawmakers navigate these complex issues, the coming weeks will be crucial in determining the future of health insurance coverage for tens of thousands of people.
Governor Henry McMaster has expressed optimism that the shutdown will not extend much longer, but without a resolution to restore the subsidies, the potential for harm to individuals and families without affordable healthcare is significant. The urgency grows as the open enrollment period approaches, amplifying the need for decisive action to protect the health and well-being of South Carolinians.
Deeper Dive: News & Info About This Topic
- WPDE: South Carolina Obamacare Health Insurance Plan
- Wikipedia: Affordable Care Act
- Charleston City Paper: Health Insurance Spikes in SC
- Google Search: Health Insurance Crisis
- Post and Courier: Obamacare Subsidies Expire
- Google Scholar: Obamacare Subsidies South Carolina
- NBC News: Lindsey Graham on ACA Subsidies
- Encyclopedia Britannica: Health Insurance
- New York Times: Obamacare Enrollment Map
- Google News: South Carolina Health Insurance

Author: STAFF HERE FLORENCE WRITER
The FLORENCE STAFF WRITER represents the experienced team at HEREFlorence.com, your go-to source for actionable local news and information in Florence, Florence County, and beyond. Specializing in "news you can use," we cover essential topics like product reviews for personal and business needs, local business directories, politics, real estate trends, neighborhood insights, and state news affecting the area—with deep expertise drawn from years of dedicated reporting and strong community input, including local press releases and business updates. We deliver top reporting on high-value events such as the Florence Festival of Lights, Pee Dee Pride, and agricultural expos at the Florence Center. Our coverage extends to key organizations like the Florence Regional Chamber of Commerce and the Pee Dee Area Council of Governments, plus leading businesses in healthcare and retail that power the local economy such as McLeod Health and Pee Dee Electric Cooperative. As part of the broader HERE network, including HERECharleston.com, HEREColumbia.com, HEREGreenville.com, and HEREHiltonHead.com, we provide comprehensive, credible insights into South Carolina's dynamic landscape.