Members of a planning committee dominated by the governor's appointees insisted Wednesday they reached their own conclusions about how the state should implement federal health care reform.
One Democrat on the committee, though, said the panel's November report drew foregone conclusions.
The comments follow a story Wednesday in The Post and Courier detailing newly released emails that show Gov. Nikki Haley ordered the panel's findings in March, before the group met for the first time.
The Health Planning Committee's findings mirrored Haley's directive that "the whole point of this commission should be to figure out how to opt out and how to avoid a federal takeover, NOT create a state exchange."
A central part of the federal health care overhaul, an exchange is a marketplace where various insurance plans eventually will be sold.
Evelyn Perry, a Charleston small-business owner whom Haley appointed to the panel, called the governor's emails "distasteful" but said the group agreed on the final recommendations without being directly influenced.
"In my mind, I think it was a legitimate conclusion," Perry said. "The amount of research and work that went into it -- I don't think that went down the drain."
But at least one member of the committee took a dimmer view.
S.C. Rep. David Mack, a Charleston Democrat appointed by S.C. House Speaker Robert Harrell, said he resigned himself to being a minority voice on the committee from the start.
"You could tell by the composition of that committee what the result was going to be," he said. "It was handpicked. The numbers are set to get a certain outcome."
Haley established the 12-member group in a March executive order and personally appointed five panelists. Two more, Tony Keck, director of the S.C. Department of Health and Human Services, and David Black, director of the S.C. Department of Insurance, are state Cabinet members. Keck was copied on the email that contained Haley's orders about the committee's eventual findings. The panel used part of a $1 million federal "Exchange Planning" grant to conduct research and hire contracted staff.
The committee rejected a federally run exchange, saying the federal government has not provided sufficient information about how it would operate. It also dismissed having a state-run exchange, saying it would be too costly and could carry liabilities. The group recommended a "wait and see" approach that would encourage private businesses to set up their own exchanges. States that fail to set up their own exchanges by 2014, however, will be subject to federally run ones.
"The governor has said all along that she wanted to look for alternatives," said Keck. "We had amazing consensus on such a contentious issue."
Keck rejected criticism that the governor had undue influence over the process through him.
"It just couldn't have happened," given the number of people involved in discussions, he said.
Keck, who wrote key portions of the report, continued, "She (Haley) had an opinion. Everyone at the table had opinions too."
The panel and members of its subcommittees met more than 30 times between April and November.
Casey Fitts, a Charleston physician appointed to the panel by Republican S.C. Sen. Glenn McConnell, Senate president pro tempore, said he entered discussions in "very strong" support of a state-run exchange. But he changed his opinion by the end of the planning process, instead favoring something "unique to South Carolina," he said.
Fitts, who runs a medical clinic that offers discounted treatment to the working poor, said the primary reason behind his change of opinion involves the long-term cost of operating an exchange.
But the emails that surfaced this week left him with questions about the discussions.
"I'm trying to digest and think through the process," he said. "Was I an unwitting stooge through this process that was predetermined?"
He continued, "We had frank discussions about health care, and none of that was swept away."
S.C. Sen. Michael Rose, a Dorchester Republican who also was appointed by McConnell, said he "went to 35 meetings in five months, costing me thousands of dollars personally to research these issues and draw my own conclusions."
"(Haley) might have dictated them to Tony Keck, but that's different than dictating to me," he said.
Gov. Nikki Haley's office for the second day deflected questions about why emails that surfaced Friday were not included in a response to a public records request in May.
Haley's office did not release emails exposing its influence over a nonpartisan health care committee, instead releasing innocuous materials when The Post and Courier asked for documents related to the panel.
Revelatory emails surfaced Friday after a different state agency responded to a separate request for documents under the South Carolina public records law.
The two requests are nearly identical.
The governor's response contained press releases, public schedules and some correspondence among staffers, but no emails from the governor.
Haley's office offered no explanation for the discrepancy Tuesday or Wednesday.
Jay Bender, an attorney for the S.C. Press Association, called the lack of response "unacceptable."
Members of the South Carolina Health Planning Committee, the group Gov. Nikki Haley established to decide whether the state should manage its own health insurance exchange:
Gary Thibault, project manager and committee chairman.
Casey Fitts, Charleston surgeon appointed by the president pro tempore of the S.C. Senate.
Sen. Michael Rose, a Dorchester Republican appointed by the president pro tempore of the S.C. Senate.
Rep. David Mack, a Charleston Democrat appointed by the speaker of the S.C. House of Representatives.
Rep. Bill Sandifer, an Oconee Republican appointed by the speaker of the S.C. House of Representatives.
Tony Keck, director of the S.C. Department of Health and Human Services.
David Black, director of the S.C. Department of Insurance.
Tim Ervolina, president of United Way Association of South Carolina appointed by Haley.
Evelyn Perry, small-business employer appointed by Haley.
Mike Vasovski, Aiken physician appointed by Haley.
Tammie King, Columbia insurance agent appointed by Haley.
Will Shrader, senior vice president at Blue Cross Blue Shield of South Carolina appointed by Haley.