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Planning limited-benefit population are assumed to be approximately 10% higher than the uninsured or ACA marketplace eligible populations. Assumed ramp-up to ultimate take-up rate Absent an enrollment cap on the Palmetto Pathways to Independence waiver program, projected enrollment assumes a period of 36 months for enrollment in the waiver to ramp up to the ultimate take-up rate and is estimated at approximately 45% of the fully implemented program in year 1, 76% in year 2, and 92% in year 3. Work requirement Work requirement activities assume employment for no less than 80 hours per month using monthly income of $580 ($7.25 minimum wage x 80 hours = $580) as a proxy for this requirement. Of the portion of non-college PCR adults subject to the proposed work requirement activities, 75% are assumed to meet the no less than 80 hours per month employment requirement based on SCDHHS review of the South Carolina Department of Employment and Workforce data. In addition, individuals in a full-time/part-time degree- or certificate- seeking program are eligible for the Palmetto Pathways to Independence waiver through the secondary education qualifying activity criteria and are therefore exempt from the work requirement. Based on review of the 2023 ACS data, approximately 7 to 8% of total eligible members are assumed to meet the secondary education qualifying activity criteria. Enrollment trend Enrollment growth for the Palmetto Pathways to Independence waiver is estimated at approximately 1% per year through the end of the projection period, subject to the enrollment cap. This trend is consistent with the overall population growth of South Carolina based on U.S. Census data from CY 2017 through CY 2022. Cost Estimates per Member The per capita expenditures for the Palmetto Pathways to Independence waiver population are developed from the state fiscal year (SFY) 2025 projected expenditures for individuals currently enrolled in the South Carolina Healthy Connections Medicaid managed care program, adjusted to reflect pent-up demand and morbidity. Costs per member are assumed to increase at an annual rate of 6%, consistent with the president’s trend used in the Congressional Budget Office’s (CBO) Medicaid expenditures projections. Table 4 illustrates year one through year five PMPM projections for the Palmetto Pathways to Independence waiver population. Table 4: Palmetto Pathways to Independence Waiver Projected PMPMs Demonstration Years (DY) DY 01 DY 02 DY 03 DY 04 DY 05 Estimated PMPM $ 870.77 $ 903.65 $ 945.22 $ 1,001.95 $ 1,062.09 13