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process. 6 Program Operations Commentor provided input on how the state may want to operationalize the program to be efficient and effective. 19 Proposed Changes to the Waiver Application Several policy changes were suggested. Details are noted below. 30 Supports Working Families Commentors noted the benefits of healthcare access for low-income working families. State Response to Comments A detailed summary of all public comments received is provided below. This summary is organized by theme and includes the state’s response to those comments. Administrative Burden Comment Summary: Four commentors asserted that implementing the waiver and monitoring individual employment activity would be costly to the state. State Response: SCDHHS appreciates this comment and is working to create an implementation plan that is the least administratively burdensome for both Healthy Connections Medicaid members and applicants and the state. Specifically, SCDHHS plans to build upon data matching capabilities that exist within the current eligibility system and automate compliance monitoring as much as possible. While the specific operational details for monitoring compliance will be developed after waiver approval, SCDHHS is committed to aligning with existing policy and procedures to the greatest extent possible to gain efficiency in operations. Enrollment Cap Comment Summary: Eight commentors requested the state remove the enrollment cap and allow all qualifying individuals to be enrolled in the program. State Response: SCDHHS is committed to fiscal responsibility and operating the program within the funding that is available. Enrollment projections indicate that it will take five years to hit full enrollment. Exemptions Comment Summary: Nine commentors suggested the state add exemption criteria to the waiver including exemptions for (i) individuals who are the primary caregiver of a child and/or disabled adult, (ii) individuals with disabilities, (iii) those with transportation difficulties, and (iv) American Indian and Alaska Natives. One commentor provided an extensive list of exemptions that align with exemption listings that typically apply to programs that are inclusive of the Medicaid expansion population and are not reflective of the parent and 18