Uncharted waters lay ahead for uninsured residents who have to find coverage under the new federal health care law, says a local health center official.
In Beaufort County, 21.6 percent of residents don't have health insurance -- the fifth-highest percentage in the state, according to a report released Thursday by the U.S. Census Bureau.
On Oct. 1, the federal government will open enrollment in a new health insurance exchange as part of the Affordable Care Act. The exchange is designed to help the uninsured get coverage, a requirement under the new law. Everyone must have insurance by March 31 or face a tax penalty.
Local health officials are scrambling to find those who need to sign up for the exchange and explain what the new law means.
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"Those people who are uninsured are the ones we are trying to reach," said Gaynelle Dantzler, administrative director of reimbursement services at Beaufort-Jasper-Hampton Comprehensive Health Services. "There are lots of mixed messages, so the key thing is to make sure people understand what this law really is and what it means for them."
South Carolina has the 14th-highest percentage of people under age 65 without insurance in the U.S., according to the Census report calculated from data through 2011. With 19.4 percent of the state's population uninsured, this climbs above the nation's average of 15.8 percent.
That translates into an estimated 733,000 South Carolinians who will need to sign up for health insurance to comply with the Affordable Care Act by January, said S.C. Health and Human Services director Tony Keck.
In Beaufort County, about 26,700 people are uninsured, according to the report.
Jasper County has the highest percentage of uninsured -- with 27.4 percent, or 5,725 residents.
About 38 percent of the 18,000 people served at the Beaufort-Jasper-Hampton health center last year were uninsured, or 7,000 people, said the center's chief executive officer, Roland Gardner.
Dantzler said the law can offer great opportunities for those who have never been able to get health insurance, but those opportunities won't be realized if people don't understand their options.
"If people don't know what the new law is, what their options are, or what's best for them," Dantzler said, "then they could sign up with a plan that is not best for them" or not best for the system.
South Carolina opted not to form its own exchange and, instead, will use the federal insurance exchange. Coverage begins Jan. 1. Four companies were approved for the federal exchange in the state: Blue Choice Health Plan, BlueCross BlueShield of South Carolina, Coventry Health Care of the Carolinas, and Consumers' Choice Health Plan.
But there are still many details to work out, which has Keck concerned.
He expects that those who are currently uninsured because they can't afford coverage or because they have pre-existing conditions will sign up. But if healthy people don't buy into the system, then it could fail, he said.
There is a $95 penalty for adults who don't have insurance March 31, but Keck said he worries some would rather pay the penalty than buy a policy.
"The fear is that when health exchanges go live, they will be swarmed with sick, older people, and that will bankrupt insurance plans because not enough healthy young people have enrolled," Keck said.
That's where public outreach comes in, Keck said.
Government, insurance and health agencies in South Carolina are part of that outreach.
A state Department of Insurance spokeswoman said the agency is revamping its website to make more information and resources available.
BlueCross BlueShield of South Carolina has created a website called ahealthysc.tv to help answer people's questions. Spokeswoman Patti Embry-Tautenhan said the insurer has also opened two storefronts in Greenville and Charleston and is planning to add more around the state.
"When information comes out that we're the 14th-most-uninsured population, we understand that there is a tremendous amount of opportunity for conversation," Embry-Tautenhan said. "There are a lot of important decisions to be made, and we want to be part of that conversation."
Keck said more money needs to be injected for outreach into areas with a high percentage of people with low incomes or in poor health.
The Beaufort-Jasper-Hampton health center in Ridgeland received a federal grant of $144,514 to help assist people with their health care options and enroll them in a plan, Gardner said. It was one of 19 federally qualified health centers in the state to receive the grants.
Dantzler said it is partnering with Hilton Head Hospital, Beaufort Memorial Hospital and Coastal Carolina Hospital to reach more people. The center hopes to educate around 4,000 people and enroll at least 1,400 when the exchange opens, she said.
"We cannot just sit here and look at the 7,000 patients without insurance and not work to help them get coverage," Gardner said. "I'm happy that the dollars were available, and there is an opportunity to get them insured and into some sort of system of health care."
Follow reporter Sarah Bowman on Twitter at twitter.com/IPBG_Sarah.