Considering the magnitude of proposed Medicaid changes in South Carolina, it's not surprising that several high-profile advocacy groups already have lined up to criticize or outright oppose the dramatic reforms. Gov. Sanford's plan to establish personal health accounts next year to pay for the medical expenses of 700,000 S.C. Medicaid recipients deserves a chance to succeed. But the changes are far-reaching and untested -- and therefore deserving of vigorous public skepticism and scrutiny.

The pointed questions being asked by AARP and the NAACP are a welcome addition to the Medicaid debate in a state not particularly strong on advocacy for children, the poor, the disabled and the elderly. Those are the South Carolinians covered by the state-federal Medicaid program. The $4.5 billion program pays for more than half of all births in the state and insures more than 40 percent of the children and nearly 30 percent of its senior citizens. Two national public policy institutes also are opposing the changes.

Gov. Mark Sanford's plan, if approved by the federal government, would give Medicaid recipients -- mostly children (520,000) -- a fixed amount of money in personal health accounts to pay for medical expenses. Patients could use the account to buy medical insurance. Any money left over could be used to pay deductibles with a debit card.

Advocacy groups are posing appropriate questions. What happens when a patient spends all his or her money in a personal account? Will the money in personal accounts be sufficient to cover particularly costly and life-threatening chronic illnesses such as heart disease, cancer and diabetes? Will the money be adequate to cover the births currently covered by Medicaid?