S.C. Gov. Henry McMaster ordered the state’s health agency Friday to remove abortion providers from its Medicaid provider network.

Separately, the Richland Republican ordered the state agency to use money it has left over from last year’s budget to fill a hole he created last week in the budgets of other health clinics that serve low-income South Carolinians.

That hole was created when McMaster, in an effort to remove any money for Planned Parenthood from the state’s 2018-19 budget, vetoed almost $16 million to pay for health care services for low-income South Carolinians.

That budget took effect Thursday.

“Although the state should not contract with abortion clinics for family planning services, the state also should not deny South Carolinians’ access to necessary medical care and important women’s health and family planning services,” McMaster said in his order Friday.

Critics have blasted McMaster’s veto, calling it a political stunt aimed at buying votes before he faces Democratic state Rep. James Smith in November’s election.

“As governor, I will understand the impact of my vetoes before I make them,” said Smith, who won the Democratic nomination for governor in June. “I would never play political games with the health care of the people of South Carolina.”

S.C. Department of Health and Human Services spokeswoman Colleen Mullis did not respond to questions about the executive order on Friday.

‘A fight he’s willing to fight’

Advocates for low-income South Carolinians say McMaster’s order Friday could be challenged in court.

Sue Berkowitz, head of the S.C. Appleseed Legal Justice Center, said she is glad McMaster will allow more than 4,000 health care providers access to money to serve low-income South Carolinians. “We were concerned he was going to be cutting off family planning for everyone.”

Berkowitz added, “There’s still a huge legal issue of network adequacy, and you can’t just kick a provider of choice (Planned Parenthood) off. … I feel his executive order is still in violation of Medicaid laws.”

According to federal law, Medicaid recipients can choose their health care provider.

While states can restrict those choices through managed care arrangements, they can’t do so for family planning providers, according to the nonpartisan Center on Budget and Policy Priorities.

McMaster spokesman Brian Symmes told The State newspaper on Friday that the governor is willing to fight to kick Planned Parenthood out of the S.C. Medicaid program.

“The governor has been very clear, for over a year and a half now, that he firmly believes no taxpayer dollars should directly or indirectly subsidize abortion, and this is another step in that direction,” Symmes said. “And it’s a fight he’s willing to fight.”

A spokesperson for the Centers for Medicare and Medicaid Services, the federal agency that oversees the joint federal-state Medicaid system, was not immediately available for comment Friday.

‘Public health consequences’

Last Friday, McMaster vetoed $16 million in health care money from the state’s budget in an effort to defund Planned Parenthood, which receives less than $100,000 of that money, none for abortions.

However, the Legislature will not return to Columbia to take up McMaster’s vetoes until September.

McMaster’s veto and the loss of state money created confusion statewide among health care providers, unsure about how many low-income patients could be affected.

A quarter of South Carolinians — about 1.2 million of nearly 5 million — get their health care through Medicaid. Roughly 70 percent are children, senior citizens or disabled, while 30 percent are “other adults,” which includes able-bodied adults.

Planned Parenthood — which sees roughly 5,000 men, women and young adults a year — gets a small sliver of state and federal tax dollars to cover nonabortion services, including birth control and testing for sexually transmitted diseases.

In 2017, the abortion provider’s two clinics, in Columbia and in Charleston, got less than $85,000 of the $42 million paid out to Medicaid providers, according to the state Office of Revenue and Fiscal Affairs. None of this money went to pay for abortions, except in cases of rape, incest or when a woman’s life was in danger — all covered by federal law.

Cutting Planned Parenthood from the state’s Medicaid network could result in more unwanted S.C. pregnancies, said Sarah Riddle, spokeswoman for Planned Parenthood South Atlantic.

“We’ve seen that states that have restricted or excluded Planned Parenthood’s participation from their Medicaid programs have suffered disastrous public health consequences,” she said.

When Texas eliminated Planned Parenthood from its family planning program, the University of Texas at Austin found that women had reduced access to the full range of contraceptive methods and experienced higher rates of unintended pregnancies.

Also, women lost access to affordable reproductive health care, either because there were no other providers in their community or because other clinics could not serve all of Planned Parenthood’s patients, Riddle said.

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SC Gov. McMaster issues order to boot Planned Parenthood as a Medicaid provider