Every week since rural Barnwell County lost its hospital in 2016, Julie Edwards has had to drive 45 minutes from Williston to Aiken to see doctors for several conditions, including diabetes.
But Friday, the 30-year-old Medicaid recipient hitched a ride to BlueCross BlueShield in Columbia to advocate for thousands of S.C. Medicaid patients who may lose their ability to seek health care at three clinics operated by the state's abortion providers.
"We can't have women showing up to the emergency room for Pap smears," Edwards said at a hearing held by the S.C. Department of Health and Human Services, which administers Medicaid benefits. "We can't have them showing up to emergency rooms for thyroid tests."
The state's three abortion clinics — which include two run by Planned Parenthood — now accept patients who are on Medicaid, providing a range of medical services other than abortions. But a waiver requested by Gov. Henry McMaster — and sparked by the Columbia Republican's 2017 executive order to defund abortion clinics — could force the clinics to drop their Medicaid patients.
With the waiver, McMaster is asking the federal government to exempt the state's abortion clinics from South Carolina's network of Medicaid providers — part of an effort to drive abortion providers out of South Carolina.
"This is about life," McMaster told reporters this week. "If you're not alive, you don't need a highway. You don't need anything."
DHHS will send the waiver application to the federal government in July.
If approved, critics worry the waiver will create a public health crisis in South Carolina, driving up birth rates — particularly among teenagers — and curtailing Medicaid recipients from getting the health care services they need.
"If Planned Parenthood closes, what we know is that the existing provider network cannot absorb those patients," said Vicki Ringer, spokeswoman for Planned Parenthood South Atlantic. "The county health departments, the federally qualified health centers, free clinics, other providers ... have said they cannot absorb all of our patients, then be able to treat those patients."
Planned Parenthood in Columbia and in Charleston see about 5,000 men, women and children a year. Most of those patients are uninsured or get their health benefits through Medicaid.
Beyond abortions, the clinics offer health and family services, including testing for sexually transmitted diseases, gynecological exams and contraceptives that are reimbursed by federal Medicaid dollars. The state gets about $34 million a year from the federal government for those "family planning" services, a tiny percentage of which flows to abortion providers.
For example, Planned Parenthood received about $82,000 in Medicaid reimbursements from the state in 2017, Ringer said.
Critics slammed the governor's waiver request Friday, saying McMaster is putting politics over public health. The governor is running in the June 12 Republican primary to keep his job.
"You didn't ask us," Edwards said of McMaster, who was not at Friday's hearing. "You made us a political tool, and I'm sick of it."