Walhalla, SC – Nestled in Blue Ridge mountain buttresses, a small primary care clinic led by the University of Clemson attracts patients from the whole region. Many are Hispanic and not insured, and some are ready to travel to other counties, bypassing closer health care providers, just to be seen by Michelle Deem, nurse bilingual practitioner of the clinic.
“Patients who speak Spanish really prefer a Spanish -speaking supplier,” said Deem. “I learned this community quite well.”
Clemson does not manage a academic medical center, and he does not manage a medical school. We can say that the public university is best known for its football program. However, with millions of dollars intended for state legislature, he extended to the provision of health care, with clinics in Walhalla and beyond. School managers are trying to fill the gaps in rural regions and unpreosedy of a state where health results are regularly classified among the worst in the country.
“Some of these communities have such a high need,” said Ron GimbelDirector of Clemson Rural Health, who operates four clinics and a fleet of mobile health units as part of the College of Behavior, social and health sciences at the university. “They have so many obstacles that have an impact on their ability to be healthy.”
Clemson Rural Health is one of the many programs that try to meet this need in the state.
“Rural health is fashionable,” said Graham Adams, CEO of the Southern Carolina Rural Health Office.
State legislators at the national level spend millions of dollars to combat a crisis in rural health care in manufacturing. For more than a decade, however, the legislatures controlled by the Republican in most Southern states have refused billions of federal funds that would offer public health insurance coverage to low -income adults. These are the same states where disparities in racial health and health results are often worse than in other regions.
Almost every state has extended Medicaid cover For women in the months that gave birth. But 10 states I have not entirely widened the coverage of Medicaid with federal money made available under the Act respecting affordable care of 2010. Seven of these states – Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee and Texas – are in the south. With a few exceptions, adults without children in these states are not eligible for coverage of Medicaid, regardless of their level of income.
Georgia Governor Brian Kemp and South Carolina Governor Henry McMaster, both Republicans, recently announced his intention to extend Medicaid in a limited manner to include certain parents. The Southern Carolina Plan would impose working requirements on some of these new MEDICAIDE beneficiaries, while the Georgia plan would allow certain parents of young children to bypass existing state work rules. Both plans require federal approval.
Jonathan OberlanderA professor and a health policy scholarship holder at the University of North Carolina, said that he did not expect to see any of the remaining states rushing to fully enlarge Medicaid. Before Donald Trump took office on January 20, Washington Republicans had already expressed their intention to considerably reduce expenses for Medicaidwhich covers 72 million people at a cost of almost $ 900 billion.
“There is a large gray cloud that weighs on the expansion of Medicaid at the moment, and it is because there is so much uncertainty about what the Trump administration and the republicans of the Congress will do”, declared Oberlander.
Even thus, in South Carolina this year COVERS PLAIDOY GROUP Plans to put pressure on the general meeting to adopt a bill to adopt the expansion of Medicaid, said Beth Johnson, regional director of government relations for the American Cancer Society Cancer Action Network and member of the Board of Directors from Coversc. The state legislative session began on January 14.
If such a measure was approved, the federal government would cover 90% of the state’s medicadid expansion costs and southern Carolina should pay 10%, or around 270 million dollars in the first year, according to A 2024 report by the Milken Institute School of Public Health from George Washington University.
In the 10 non -expanding states – which, outside the south, also include Kansas, Wisconsin and Wyoming – approximately 1.5 million people fall into a coverage gap, according to 2024 KFF estimatesThe Health Information For non -profit which includes Kff Health News. This means that they are not eligible for coverage of Medicaid or financial assistance to buy insurance via the federal market.
Many people who would be eligible for Medicaid if these states were to extend eligibility are concert workers, Johnson said. They play music, lead to Uber or deliver pizza, and they are generally not eligible for health insurance through their work.
“They provide services that we all appreciate,” she said. “And they just can’t afford health insurance.”
In some Southern Carolina communities, Clemson Rural Health tries to fill this gap by providing primary care, cancer screening, nutritional education and diabetes management for free patients or at reduced rates. Only about half of the patients seen by Clemson Rural Health have health insurance, said Gimbel, against 92% of the American population.
During the current state financial year, Clemson Rural Health was taken out by a $ 2.5 million contract, its greatest source of financing, the State Department of Health and Social Services, which Administering Medicaid in South Carolina and operates with a budget approved by state legislators.
This is a relatively low amount of money compared to the $ 47.5 million that state legislature has given to the South Carolina Medical University in recent years to settle in rural communities. Musc served Charleston for most of his 200 years of history, but since 2019, he has widened through the State by buying, building or associating seven rural hospitals – some on the verge of the Closure – and an autonomous emergency service. Musc is expected to open an additional rural hospital this year.
Other states have made similar investments. The University of Georgia, for example, has created a new medical school, in part to send more doctors to poorly served and rural areas. The General Assembly of Georgia has launched half the cost of a new $ 100 million building for medical education and research in Athens.
Meanwhile, the General Assembly of Tennessee adopted a budget last year which included $ 81 million for various rural health initiatives.
Apart from southern, the legislatures of the states of Colorado, Nevada, Virginia-Western and elsewhere have made recent investments in rural health, in addition to expanding the eligibility for Medicaid.
Some of these expenses have been caused by a wave of rural hospitals – more than 100 Since 2010, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.
We do not yet know what long -term impact some of these initiatives will have – for example, if the Clemson program “will reduce premature mortality, reduce avoidable hospitalizations and improve the quality of global life”, as it aims to do, according to , according to Son website. Some public health experts point out that strengthening the number of rural clinics, hospitals and doctors in the South does not matter if patients cannot afford to make an appointment.
“The lack of ability to pay is one of the biggest obstacles,” said Adams, the chief of rural health.
Oberlander said that conservative legislators often consider projects such as the construction of new rural clinics more politically acceptable than expanding Medicaid coverage.
“The more you get the ACA, the less polarized the health care policy,” he said.
President of the South Carolina Senate Thomas AlexanderA republican who lives in Walhalla, said that the General Assembly was willing to invest in certain rural health initiatives to improve access to health care.
“It is not because you expand Medicaid that you have extended access to services,” said Alexander. “I want to focus on expanding access to services.”
Gimbel would not comment on the expansion of Medicaid in South Carolina, and he said that it was too early to know how federal Medicaid changes under the Trump administration could affect the funding of Rural Health, which is currently receiving The money from the State Medicaid agency. But doing the financially solvent Clemson program could take several more years, he said.
“If rural health was profitable,” he said, “we would not have a rural health problem.”