South Carolina has 2nd-highest medical debt levels in the U.S., but little hope of expanded Medicaid coverage

Sue Berkowitz’s son was born in 1993 with a heart defect. Three years later, Berkowitz and her husband lost their health insurance when her nonprofit employer lost its funding. Private insurance denied her 3-year-old son health coverage because of his pre-existing condition.

Berkowitz was already working in health advocacy, but after her experience with her don, she became even more invested in her health advocacy and legal work in South Carolina. She worked to get votes from South Carolina to help pass the Affordable Care Act in 2010, which prohibits insurers from denying coverage due to a preexisting condition. Berkowitz cried as she watched the bill pass.

“I still remember sitting next to my son, who goes, ‘Well, I know you’ve been working hard for this,’” Berkowitz recalled. “I said, ‘I’m crying because you won’t be turned down for insurance once you’re on your own.’”

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Two years later, South Carolina legislators made it clear Medicaid expansion would not be taken up there. Berkowitz, director of the South Carolina Appleseed Legal Justice Center, has been advocating for expansion ever since.

South Carolina is one of 12 states that has not expanded

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