COLUMBIA, S.C. - South Carolinians will pay higher insurance premiums if the state fails to adequately fund Medicaid, according to organizations supporting a cigarette tax increase that would help the financially hemorrhaging health care program.

A coalition representing health-care providers, advocacy groups and businesses increased pressure on lawmakers Monday to approve a tobacco tax increase to make up for a Medicaid funding shortfall of about $80 million. The state's current cigarette tax - 7 cents a pack - is one of the lowest in the nation.

The Cigarette Tax for Health Care coalition released a study that said the cost of caring for the state's uninsured will be shifted to those who pay for private health insurance.

"We're going to be taxed one way or the other," said Edward Sellers, president and chief executive of Blue Cross Blue Shield. "If we don't pass the cigarette tax in order to have full funding of Medicaid, that same cost will flow through the cost structure of hospitals, physicians and clinics and wind up in the health insurance premiums of Blue Cross Blue Shield, Cigna, Etna, CCP (Carolina Care Plan) and all the other health care payers."

Coalition members said the $80 million shortfall means hospitals will have to pay more to treat residents who will no longer be covered by Medicaid, which is funded with nearly 70 percent in matching federal dollars.

A 10 percent cut in total Medicaid funding to hospitals could increase medical costs for hospital services alone between $107 million and $243 million, the study said, but it did not have data on the effect of cuts on physicians, clinics and other health-care providers.

State Chamber of Commerce chief executive Hunter Howard said his group paid for the $15,000 study in order to document the cost shift.

The House was to begin debating the state's $5.1 billion budget Tuesday, but there's no cigarette tax in the bill. Many legislators pledged not to raise taxes, and Gov. Mark Sanford has said he would support a tax increase only if it was tied to a corresponding decrease.

An amendment to the budget bill could introduce the cigarette tax during the budget debate, but the coalition is pushing for reform in the Medicaid program and a tax increase.

The House Medicaid Reform Ad Hoc Committee is wrapping up work on a bill that moves several smaller agencies into the departments of Health and Human Services, Social Services and Vocational Rehabilitation.

The committee Monday did not debate a plan to increase cigarette taxes by 42 cents a pack, which would be added to the state's current 7-cent tax.

The extra money, about $150 million, mostly would support Medicaid programs but also would go into health initiatives tied to reducing obesity, binge drinking, smoking and other programs.

"It's definitely crunch time," Sellers said. "It's not an issue about tax or no tax. It's an issue of whether we do it on top of the table or under the table."