A number of states have sought Section 1115 research and demonstration waiver authority to implement changes to eligibility and enrollment policies, benefit design, and cost-sharing requirements for low-income adults who are not eligible for Medicaid on the basis of disability.
South Carolina received approval for two demonstrations. The Healthy Connections Works demonstration applies work and community engagement requirements to parent and caretaker relatives already eligible under the state plan, as well as to beneficiaries receiving transitional medical assistance. The Palmetto Pathways to Independence demonstration extends coverage to additional individuals and applies work and community engagement requirements to newly eligible members.
This fact sheet summarizes the main design features of two South Carolina demonstrations, including eligibility and enrollment policies, covered benefits, required premiums and cost sharing, and how services are delivered (i.e. by fee for service or managed care).
The information in this fact sheet is current as of June 2020. However, the Biden Administration withdrew approval for the Healthy Connections Works demonstration on August 10, 2021 (CMS 2021). While the Administration also withdrew approval for work and community engagement requirements in the Palmetto Pathways to Independence demonstration, other elements of the demonstration remain in effect (CMS 2021).
