Medicaid Recipients in South Carolina and the United States
Begun in 1970, Medicaid pays for medical care and nursing home care for the poor. Since 1980, inflation-adjusted Medicaid spending in South Carolina has increased 700% to $6.35 billion in 2017. At the same time, the number of Medicaid recipients increased 279%, from 277,000 in 1980 to almost 1.05 million.
In 2017, approximately 74.6 million Americans received some level of Medicaid assistance, the total cost of which was $590.4 billion in inflation-adjusted dollars. Of the amount spent nationally in 2017, 49.3% was spent on managed care and premium assistance, 13.4% was spent on inpatient hospital expenses, 11% was spent on home- and community-based long-term services and support, and 10% on institutional long-term services and support.
 Recent state recipient data from University of South Carolina Institute for Families in Society, Division of Integrated Health and Policy Research, South Carolina eHealth Medicaid Statistics, June 2018. Available at www.schealthviz.sc.edu/medicaid-enrollment. Access verified Oct. 25, 2018. Recent national recipient data from Henry J. Kaiser Family Foundation, “State Health Facts: Total Monthly Medicaid and CHIP Enrollment.” Available at www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/. Access verified Oct. 25, 2018. Older data from U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services, Medicare & Medicaid Statistical Supplement, 2013 Edition, and earlier editions. May 5, 2017. Available at www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Archives/MMSS/index.html. Access verified Oct. 25, 2018.
 Medicaid and CHIP Payment and Access Commission (MACPAC), “Exhibit 17. Total Medicaid Benefit Spending by State and Category, FY 2017,” July 20, 2018. Available at www.macpac.gov/publication/total-medicaid-benefit-spending-by-state-and-category/. Access verified Oct. 25, 2018.
Percent of Population Enrolled and Benefit Payments to South Carolina
Medicare was established in 1965 as a means of establishing a health insurance program for aged persons to complement the retirement, survivors, and disability insurance benefits under Title II of the Social Security Act. When first implemented in 1966, Medicare covered most persons aged 65 or older. Since then, it has expanded to include persons entitled to Social Security or Railroad Retirement disability cash benefits, most persons with end-stage renal disease, and those with Lou Gehrig’s Disease.
Since 1999, enrollment in Medicare in South Carolina has risen from 14.3% of the state’s population to 19.6% in 2016, an increase of 37%. Nationally, enrollment has risen from 14.1% to 17.6%, an increase of 25%.
While enrollment has increased by a bit more than a third, inflation-adjusted payments to Medicare enrollees have risen by 53%, from $246.6 million in 1999 to $377.8 million in 2016.
 Social Security Administration, Annual Statistical Supplement 2012, Feb. 2013. Available at www.ssa.gov/policy/docs/statcomps/supplement/2012/supplement12.pdf. Access verified Oct. 30, 2018.
Rates Per 100,000 Population
Chlamydial infections, which usually have no symptoms, may result in damage to a woman’s reproductive organs, including pelvic inflammatory disease (PID)—a major cause of infertility—ectopic pregnancy, and chronic pelvic pain. Since 1984, South Carolina’s chlamydia infection rate has increased 2,525%, while the national rate has increased 15,250%. In 2016, South Carolina had the seventh highest rate of chlamydia cases in the nation. One of the reasons for these large increases appears to be because of improvements in screening techniques.
While chlamydia is the new leader in sexually transmitted infections in both South Carolina and the United States, gonorrhea and syphilis are on the decline. As with chlamydia, gonorrhea and syphilis produce PID, abdominal pain, and ectopic pregnancies. Since 1984, gonorrhea infection rates in South Carolina and the United States have decreased by 72% and 62%, respectively.
Syphilis is a bacterial infection that is particularly dangerous to unborn children. If untreated, many children of mothers with syphilis are stillborn or die shortly after birth. For syphilis, rates have fallen 60% in South Carolina and 8% nationally. In 2016, South Carolina ranked 22nd nationally regarding its rate of syphilis cases.
 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Prevention, Sexually Transmitted Disease Surveillance 2016, Sept. 2017, Available at www.cdc.gov/std/stats16/CDC_2016_STDS_Report-for508WebSep21_2017_1644.pdf. Access verified Oct. 30, 2018.
 Ibid, and earlier editions.
Rates Per 100,000 Population
Human Immunodeficiency Virus infection (HIV) is a disease of the immune system. While the disease can be managed through antiretroviral therapy, which can help patients achieve near-normal life expectancies, there is no cure for HIV. If left untreated, about half of all persons with HIV eventually develop Acquired Immune Deficiency Syndrome (AIDS) within 10 years of infection.
In 2016, there were 18,409 new diagnoses of HIV infection in the 50 states and the District of Columbia. Of these, 369 were in South Carolina. Since 1985, the rate of AIDS has increased 19% nationwide and 347% in South Carolina. In 2016, South Carolina’s AIDS rate (7.44 per 100,000 population) was 31% higher than the national average (5.69).
In 2016, the most common age for new diagnoses of AIDS was 25-29-year-olds (34.8 per 100,000 population), followed by 20-24-year-olds (30.3).
At the end of 2015, there were 973,846 persons living with HIV in the United States. Of these, 16,224 lived in South Carolina. Nationwide, the plurality of those living with HIV are black (42%), followed by whites (31%) and Hispanics (22%).
Among males, most (71%) acquired HIV via male-to-male sexual contact, heterosexual contact (10%), injection drug use (10%), or both (7%). For females, the primary sources of contact were heterosexual contact (75%) and injection drug use (22%).
The reason for the increase in AIDS rates in 1993 is because the Centers for Disease Control and Prevention (CDC) revised its AIDS surveillance case definition to include adolescents and adults with low CD4 (T-cell) counts, but no manifestation of any signs of illness.
 Gerald L. Mandell et al., eds., Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases (7th ed. 2010).
 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Prevention, Diagnoses of HIV Infection in the United States and Dependent Areas, 2016, vol. 28, Nov. 2017. Available at www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2016-vol-28.pdf. Access verified Oct. 30, 2018.
 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Prevention, HIV/AIDS Surveillance Report, 2007, vol. 19. Available at www.cdc.gov/hiv/surveillance/resources/reports/2007report/pdf/technicalnotes.pdf. Access verified Oct. 30, 2018.