Abortion providers in South Carolina may be cut off from Medicaid funding if the federal government approves a request submitted last week by Gov. Henry McMaster's administration.
In a document sent to the federal Centers for Medicare & Medicaid Services on Thursday, state officials acknowledged that critics have called the request a "disgraceful, thinly veiled attempt to defund Planned Parenthood."
McMaster has been recently vocal about stripping Planned Parenthood of any government money. In July, he vetoed $16 million in family planning funds from the Medicaid agency's budget to stop a small fraction of it from ending up at Planned Parenthood. One week later, he instructed Medicaid to continue funding family planning but asked agency officials to exclude Planned Parenthood clinics from its provider network.
While government money may not be used to pay for abortion, except in cases of rape, incest or when a mother’s life is jeopardized by her pregnancy, abortion clinics in South Carolina offer other health care services, such as pelvic exams, that qualify for Medicaid reimbursement.
In response to McMaster's executive order, Planned Parenthood filed a lawsuit against his administration in late July, arguing that Medicaid beneficiaries have a right to seek family planning services at the provider of their own choosing.
None of this was mentioned in the letter McMaster sent Thursday to the federal government. Instead, he wrote, the S.C. Medicaid agency wants to improve "preconception care" for low-income beneficiaries of the program.
"South Carolina has made great strides in recent years to improve infant and maternal health among Medicaid beneficiaries," McMaster wrote. "To continue this success, we will pursue a comprehensive approach to care that manages a myriad of health services for our beneficiaries, supports clinical practices that integrate care, and promotes providers that seek to improve the collective health and well-being of both parents and children."
South Carolina has a higher infant mortality rate than most states. Meanwhile, as the number of babies born here has steadily decreased over the past decade, the number admitted to neonatal intensive care units each year has climbed.
Data published by the state health department shows nearly 1,000 woman gave birth in South Carolina last year having received no prenatal care at all. And 11 counties lack a single OB-GYN.
Improving infant well-being has been a priority for the state Medicaid agency in recent years because the department pays for approximately half of all births in South Carolina. Many women qualify for special Medicaid eligibility when they become pregnant.
If McMaster's request is approved, abortion providers would not be eligible to offer health care services to Medicaid beneficiaries. State officials explained in their application the program will focus on providers that can "adequately care for the overall health needs of the Medicaid members they serve."
Furthermore, the application argues, health care delivered outside the patient's "primary care medical home results in fragmented care and threatens the integrity of the delivery model. Identifying and treating chronic disease, such as diabetes and hypertension, are critically important to ensuring high quality preconception care."
Vicki Ringer, director of public affairs for Planned Parenthood South Atlantic, issued a statement Monday criticizing the proposal. She said it would restrict Medicaid patients' choices.
“We will continue to stand up for our patients, no matter what, in the face of repeated attempts by Governor McMaster to exclude Planned Parenthood South Atlantic from the state's health care network," Ringer said.
In the official application, state officials objected to the idea that McMaster's request is "political in origin." S.C. Medicaid spokeswoman Colleen Mullis said the federal government is not bound by a specific time frame in making a decision about the request. Texas submitted a request last year to exclude abortion providers and has not received an answer.
McMaster spokesman Brian Symmes said Monday McMaster wants to ensure that taxpayer money does not "directly or indirectly subsidize abortions."
"This is simply a case of him following through on a promise that he made to the people he serves," Symmes said.
The federal government will eventually open the proposal for public comments.