There are about 105,000 other South Carolinians who fall into a health insurance coverage gap created by factors that were set into motion about a decade ago. In 2012, the Supreme Court upheld the constitutionality of the Affordable Care Act for the first time. But, there was a caveat. The court said it was up to states to decide if they would expand Medicaid, the state and federal program that provides health coverage to people with low incomes. Most states signed on. South Carolina did not. Ten years in, South Carolina remains one of only 12 states that has not expanded its Medicaid program under the ACA. Republican leaders in Columbia have long contended that South Carolina can’t afford it. Today, health editor Lauren Sausser will break down that almost 10-year-old decision and why it was one of the most significant health care policy choices state leaders have made this century. We also spoke with Christian Soura, a former Medicaid director for South Carolina who’s now  the executive vice president at the S.C. Hospital Association, about the cost that comes with not expanding Medicaid coverage in the state. : 10 years after Affordable Care Act decision, 105,000 in SC still in insurance coverage gapAre there any stories you'd like to hear on the show. Contact us at [email protected] .

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