COLUMBIA – Some South Carolina lawmakers are seeing their health plan as the next step in reducing unwanted pregnancies that can end in abortion.
The health insurance plan for more than 500,000 public sector South Carolinians specifically prohibits birth control coverage for employees’ children.
This serves as an unnecessary barrier to young women trying to be responsible with the support of their parents, Dr. Kristl Tomlin, a gynecologist specializing in adolescent gynecology.
“That means your college student … is not covered by this plan, the largest in the state, and I run into this hurdle every day in my office,” the Columbia specialist said, pointing to a screen of the Plan’s policy. State Health. .
“This is kind of a travesty,” she told members of the Medical Affairs Committee.
Her testimony, which came during a nearly nine-hour hearing on whether to ban abortions in the state, renewed efforts to make contraceptives more accessible as a way to reduce front-end abortions, Sen. Tom Davis told The Post and Courier.
The Beaufort Republican was the lead sponsor of a law signed three months ago to make birth control pills and other hormonal contraceptives available in pharmacies without a prescription. But it did not address insurance. And it does not apply to teenagers under 18 years old.
State Health Plan policy change could be next, Davis and other senators from both parties said.
The State Health Plan provides insurance to the families of employees of all state agencies and public colleges, as well as school districts and local governments throughout South Carolina. Their covered dependents include about 26,300 girls ages 15 to 25, according to the Public Employee Benefits Authority, which oversees the plan.
The agency estimates it would cost $3.2 million to fully cover the cost of their contraceptives, as the plan has done for employees and their spouses since 2017 when the Legislature first inserted a clause in the state budget requiring it. .
More than 9,200 girls have contraceptives covered in part because their doctors prescribe them for reasons other than birth control. This exemption, granted through a pre-approval process, is being used with increasing frequency. Covered causes include ovarian cysts, endometriosis and bleeding disorders, according to the agency.
The $3.2 million prize includes full payment for their prescriptions and coverage for the 5,900 girls projected to newly benefit from the offer.
Sen. Margie Bright Matthews, D-Walterboro, said she expects many more to do so. The testimony came as no surprise to her, she said, because constituents have complained about it to her for years.
Regardless of the cost, South Carolina should not simultaneously restrict access to abortions and contraception, she said, noting that the parents of those girls pay for health insurance out of their paychecks.
“We’re going to pick and choose what kinds of coverage we’re going to provide to these same young women that we want to make sure they can’t have a safe abortion?” she said. “I think that’s so disingenuous.”
Changing health plan policy will require approval through the budget process, as it involves money. The 11-member board, which includes three women, cannot make the change on its own, according to a PEBA spokeswoman.
Senators tried in 2017. In addition to the clause fully covering contraceptives for employees and spouses, the senators’ budget plan included a separate clause requiring the same for dependents, starting in January 2018. The House initially agreed to it as part of the compromise sent to the desk of governor Henry McMaster.
McMaster vetoed the directive, calling it an unfunded mandate. The House supported the governor’s request, removing it from the budget.
Then-Rep. Rep. James Smith, D-Columbia, prayed for a reversal.
“The impact is quite serious when we talk about dependents, especially students in school and the costs saved from having adequate access to contraceptives,” said Smith, who unsuccessfully challenged McMaster in 2018. “It seems quite reasonable that we would do this . It seems to me that this is more of a political coup than a good move with financial responsibility.”
But the 58-54 vote fell short of the two-thirds needed, with not enough Republicans joining with Democrats to overcome.
Then-Ways and Means Chairman Brian White, among the Republicans who voted “no,” said he had heard from many constituents who opposed the coverage, without saying why.
Since then, lawmakers have not revisited the topic.
McMaster spokesman Brian Symmes said the governor’s reasoning was just what he wrote in his veto message.
“It was an unfunded mandate, which is an irresponsible way of funding government programs without a steady stream of funding to ensure the success and longevity of the program,” he told The Post and Courier.
He pointed to legislation McMaster signed in May to make over-the-counter birth control available to women 18 and older, as well as a $1.9 million reserve to the New Morning Foundation that he did not veto as evidence of the governor’s support. to make contraceptives more accessible. . It followed a $750,000 appropriation sponsored by Davis in last year’s budget for New Morning, which provides free birth control to hundreds of thousands of women across South Carolina.
Unintended pregnancies cost taxpayers up to $79 million a year in publicly funded births, neonatal and postnatal care, according to New Morning’s funding request to McMaster as he considers which budget items to veto.
Symmes echoed what McMaster said in May: “If South Carolina wants to be a pro-life state, then we have to provide the means to avoid unintended pregnancies.” But Symmes did not answer whether that meant McMaster would support birth control coverage for employees’ daughters ages 15 to 25 if lawmakers tried again and put $3.2 million on the line to pay for to.
Senate Minority Leader Brad Hutto, D-Orangeburg, said the unspoken opposition to the budget directive introduced at his request in 2017 came because Republicans didn’t want to be attacked for providing birth control to teenagers in a state. where only abstinence remains the standard for sex education in schools.
“I’m glad the issue has resurfaced,” Hutto said, vowing to reintroduce the proposal. “I will make sure we discuss this more openly than in the past.”
Implementation of the law McMaster signed in May is still a work in progress. State regulatory boards for pharmacists and medical examiners, which were given up to six months to write rules for pharmacists who want to participate, are taking written public comments on the protocols until Aug. 29.
The joint protocol committee has tentatively scheduled a meeting for two days later, a spokeswoman for the Department of Labor, Licensing and Regulation said.
If it does, they are likely to meet as the full House debates legislation to ban abortions except to save the mother’s life or prevent a serious lifelong health problem. Senators return to Columbia on September 6 to amend whatever the House sends.