South Carolina’s former Medicaid director, who resigned Friday, accepted a job this week as vice president of policy and finance at the S.C. Hospital Association.

Christian Soura, previously a Cabinet member under both Govs. Nikki Haley and Henry McMaster, notably landed at an organization that supports expanding eligibility for the low-income health insurance program — a position that his former bosses did not share.

“The political landscape is what it is and me changing jobs doesn’t really change that,” Soura said. 

A spokesman for the association said Soura’s experience will help the hospital industry in South Carolina navigate federal reform. Some congressional Republicans want to set work requirements for Medicaid beneficiaries and limit the amount of federal money states receive to administer the benefits.

In South Carolina alone the Medicaid program costs approximately $7 billion a year. Much of that money flows to hospitals in the state, all of which treat patients with Medicaid coverage. 

“If changes are made on a federal level, it completely changes what we’re going to do here in South Carolina,” said Schipp Ames, a spokesman for the S.C. Hospital Association. “Christian will be very helpful.”

Soura is the second Medicaid director in a row to leave the state agency for the hospital industry. He has held several government positions in Pennsylvania and South Carolina since 2001. He said he only intended to work in the public sector for two years. 

“It’s not like you finish. It’s not like you solve all of society’s problems and they hand you a trophy and you can move back to the private sector,” he said. “The work is never done. But I never intended to spend my entire career in government.”

His predecessor, former Medicaid Director Tony Keck, left South Carolina in 2014 for a job as vice president of a hospital system in Tennessee. 

Like Keck, Soura will soon work for an organization that supports Medicaid expansion. For years, both Medicaid directors officially opposed expanding eligibility for the low-income Medicaid program with federal funds made available through the Affordable Care Act. Experts estimate such an expansion would provide coverage to more than 100,000 uninsured people in South Carolina.

But most Republicans in South Carolina have refused to participate in the optional expansion. Haley famously told the Conservative Political Action Committee in 2013 that South Carolina “will not expand Medicaid on President (Barack) Obama’s watch. We will not expand Medicaid ever.”

Similarly, when Soura became South Carolina’s Medicaid director in 2014, he told The Post and Courier that expanding Medicaid is “not the most effective use of the resources we have at our disposal.”

Meanwhile, the S.C. Hospital Association has long supported expanding eligibility for the program in this state, where Medicaid rules make it difficult for low-income adults without children to qualify for coverage. 

“Expanding coverage is still very much a priority for us and our members. We’re just very cognizant of the situation in D.C. and the situation in South Carolina,” Ames said. “Everyone is looking towards Washington right now.”

Soura, who recently served as president of the National Association of Medicaid Directors, is expected to start working for the S.C. Hospital Association later this month. He said Haley’s departure to the United Nations in January presented a “natural” opening for him to make the move. 

“The timing is never right, but it felt right,” he said. 

McMaster has assembled a team of lawmakers and industry experts to search for Soura’s replacement. In the meantime, Deputy Medicaid Director Deirdra Singleton will serve as interim director of the agency. 

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Former Medicaid director joins South Carolina Hospital Association as vice president – Charleston Post Courier