Why drug costs are top issue for South Carolina voters

The rising cost of prescription drugs is a problem nationwide, but it's particularly acute in South Carolina, pushing the issue to the forefront when Democratic presidential contenders spar in Tuesday night's debate in Charleston.

Health care is the dominant issue among women 50 and older in South Carolina, where 78% gave elected officials poor grades in dealing with the costs of health care and prescriptions, according to a Harris Poll survey released by AARP last week.  

• How to watch the Democratic debate in South Carolina

“That should be a wake-up call to candidates,” Teresa Arnold, AARP's South Carolina state director, said in a statement issued ahead of the debate hosted by CBS News and the Congressional Black Caucus Institute.

The latest CBS News poll shows 42% of voters in the state say health care is the No.1 issue they want to hear Democratic candidates address during Tuesday's debate. Jobs and the economy were a distant second, at 30%.

One reason health care is such a crucial issue in South Carolina is the state has not expanded Medicaid, meaning a significant number of low-income residents don't have health insurance coverage, Arnold noted. South Carolina is among 14 states that have not accepted an expansion of Medicaid under the Affordable Care Act, leaving some 101,000 poor adults in the state who otherwise would have been covered without insurance, according to the Kaiser Family Foundation. 

An AARP study released in August found 27% of South Carolinians had stopped taking prescribed medication due to costs in 2016. That number rose to 33% the following year, the study showed.

The Harris findings show older women in South Carolina “are really living the hardship of high health care costs,” Tawny Saez, senior strategist for the pollster, noted. “Whatever leaders have been doing is not working for them.”

The data cast medical expenses as a personal and pocketbook issue, and one that hits African-Americans in the state even harder. Seventy percent of those polled said they knew someone without health insurance, but that figure jumped to 79% for black women, according to AARP.

“We're not a very rich state, and when people are taking four to five prescriptions a month, are they paying utility bills, putting food on the table and paying rent?” Patrick Cobb, associate state director with AARP, told CBS MoneyWatch. “The average Social Security check is about $1,300, and South Carolina is the 50th worst state for savings, so when you put the numbers together it creates a doomsday scenario for folks to afford prescriptions,” he added.

Nearly a quarter of South Carolina residents spent more than 10% of their income on out-of-pocket health care expenses in 2018, according to Shadac, a health policy research center affiliated with the University of Minnesota. That contrasts to one in five Americans nationally.

According to the Centers for Disease Control and Prevention, South Carolina ranked among the top 10 states for rates of obesity, a condition linked to diabetes and hypertension, for which medications can be costly.

The Lower Drug Costs Now Act, which passed the U.S. House of Representatives in December, would give Medicare the power to negotiate directly with drug companies to lower the price of prescription drugs for seniors who are covered by the government health insurance program. It would also make the lower drug prices negotiated by Medicare available to Americans with private insurance, not just Medicare beneficiaries.

The measure could reduce insulin costs more than 300% for the 1.5% of South Carolinians with diabetes, according to South Carolina Rep. Joe Cunningham, a Democrat. 

About 9.2% or residents in the state — roughly 361,000 people — have asthma, and the measure could lower their total costs on most drugs for dealing with the respiratory condition from about $1,400 to $270 a year, the lawmaker said in a statement that urged the U.S. Senate to pass the legislation.