Two new analyses say South Carolina’s proposed Medicaid changes will reduce health coverage and significantly raise costs to beneficiaries.

The analyses, by the Washington, D.C.-based Center on Budget and Policy Priorities and Georgetown University’s Public Policy Institute, are among the first national looks at the controversial S.C. Medicaid proposal.

According to the studies, if the waiver requested by South Carolina is granted, the state is unlikely to provide adequate dollars to cover long-term, chronic illnesses such as heart disease, cancer and diabetes, or to cover people with disabilities.

The proposal sent to Washington in June would allow for cuts in medical services to all children, the study concludes — not just 19- and 20-year-olds, as the state acknowledges.

That’s because none of the plans the state is using as a model for its new children’s benefits package offers unlimited, preventive and diagnostic medical care for children, as Medicaid does, the analyses found.

Children on Medicaid in South Carolina can go to a doctor when they need to under the current system, which critics say is important because poor children are more likely to have worse health and the worst health care.

“We wanted to get to this now, basically because there are a number of similar proposals out there — Florida’s, which has not been submitted yet, and a concept paper from Georgia — that seek major and important change to the Medicaid program,” said Judy Solomon, senior fellow at the Center on Budget and Policy Priorities.

Solomon’s analysis, “Risky Business: South Carolina’s Medicaid Waiver Proposal,” will be the subject of national media call-in today.

Since South Carolina submitted its waiver in June, state Health and Human Services director Robbie Kerr has said he doesn’t intend to cut children’s medical services.

A question-and-answer block on the department’s Web site says the state will not cut children’s benefits. “It’s there in black and white,” department spokesman Bryan Kost said Tuesday.

Under Gov. Mark Sanford’s direction, Kerr in June asked the federal agency that oversees the program, the Centers for Medicare and Medicaid Services, for at least 30 waivers, or changes, to the Medicaid program.

Last month, as legislators became aware that the waiver had been sent to Washington without public input, some asked Sanford to withdraw the request.

Medicaid, the 40-year-old medical safety net for the nation’s poor, is under pressure from the Bush administration to cut $10 billion from the ever-expanding program over the next five years.

A newly appointed commission is scheduled to make recommendations to Congress on Sept. 1 on short- and long-term ways to make those cuts.

Sanford has been pushing for cuts to the program for more than a year.

More than 52 million people get Medicaid in America, and about 850,000 residents get the nearly-free medical services in South Carolina. Of those, more than half, 520,000, are children.

“The governor’s proposal puts children’s health at risk, and it imposes substantial new costs on South Carolina’s most vulnerable children, which will impede their ability to get needed health care,” said Joan Alker, senior researcher at Georgetown’s Public Policy Institute.

“The proposal, as written, is the most radical and far-reaching waiver in the country submitted to date,” Alker said. “It is based on untested concepts that have the potential to unravel the health care safety net in South Carolina.”

Kerr said his proposal, which has touched off a firestorm of criticism in South Carolina, was designed to give Medicaid beneficiaries a sense of responsibility and more choice in their health care decisions.

The waiver asks to install co-pays of $100 for inpatient hospital visits and $25 for outpatient surgery.

Critics say Medicaid beneficiaries, who must make less than $2,000 a month for a family of three, can least afford co-pays as a percentage of their incomes.

Kost said the state is still working through some of the proposals sent to Washington.

The cost for health care is the driving factor behind Medicaid cuts.

Kerr said that Medicaid and Medicaid growth are costing the state too much money. In 2001, Medicaid expenditures cost South Carolina $562 million, part of a $5.1 billion state budget.

In 2004, Medicaid cost the state $824 million, which is 14 percent of the state’s total $5.8 billion budget.

Sue Berkowitz of the Appleseed Legal Justice Center in Columbia has been a critic of the South Carolina proposal. She also will participate in the national call-in Wednesday.

“The analyses addresses a lot of issues that need to be looked at, examined and hopefully changed,” Berkowitz said.

Reach Roddie Burris at (803) 771-8398 or rburris@thestate.com.