One week after Gov. Henry McMaster vetoed $16 million in family planning funds from the state budget, he issued an executive order instructing the Medicaid agency to continue covering "necessary medical care and important women’s health and family planning services."
He also ordered the S.C. Department of Health and Human Services "to terminate abortion clinics as Medicaid providers."
McMaster spokesman Brian Symmes told The Post and Courier on Friday that the governor's executive order means to ensure that abortion providers don't receive "a single penny of taxpayer dollars."
"I don’t think this comes as a surprise to anyone who has been listening to the governor for the past year and a half," Symmes said.
Hundreds of thousands of low-income South Carolinians qualify for family planning benefits, including pelvic exams and birth control, through the state Medicaid agency. Symmes said McMaster always intended to impact as few of them as possible in his bid to stop any government money from flowing to Planned Parenthood.
But existing federal laws mandate that Medicaid patients may seek family planning services at the health care clinics of their own choosing.
To exclude abortion providers from Medicaid family planning provider network, the agency must establish that the clinics were otherwise disqualified for some legitimate reason. For example, health care providers convicted of billing fraud have been disqualified from the Medicaid program in recent years. It is not immediately clear that any abortion provider in South Carolina has violated the rules of participation.
S.C. Medicaid spokeswoman Colleen Mullis said Friday that the governor's actions "result in abortion clinics no longer being qualified to provide family planning services to South Carolina Medicaid beneficiaries."
She did not explain how, or if, the clinics had violated any state or federal rules.
Federal 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.
But abortion clinics in South Carolina also offer other health care services, such as pap smears, that qualify for Medicaid reimbursement, too.
Planned Parenthood, for example, which operates clinics in West Ashley and Columbia, has received between $32,000 and $83,000 in Medicaid reimbursement for family planning each year, according to reports by the state Revenue and Fiscal Affairs Office.
Planned Parenthood spokeswoman Sarah Eldred said McMaster's order on Friday raises "more questions than answers right now."
The group's attorneys were reviewing the exact language on Friday, she said.
Last week, Planned Parenthood called McMaster's veto a "political stunt."
Sue Berkowitz, executive director of the South Carolina Appleseed Legal Justice Center, called McMaster's decision to exclude these providers from the Medicaid network a "violation of federal law."
"I don't think he's legally on sound footing," Berkowitz said. "You just can't do that. There has to be cause for (excluding a provider) and there has to be due process."
It's possible that a provider kicked out of the Medicaid network could bring legal action, she said.
Symmes, the governor's spokesman, said, "When it comes to a legal challenge, that’s not up to us."
The annual payments Planned Parenthood clinics in South Carolina receive represent a small fraction of total Medicaid spending in South Carolina, which tops $7 billion a year. Approximately 70 percent of Medicaid costs in this state are paid for by the federal government. Failure to comply with federal requirements could lead to a loss of that Medicaid funding.
The General Assembly intends to address McMaster's veto when it returns to Columbia in September. Meanwhile, McMaster ordered the state Medicaid agency on Friday to use "carry-foward" funds to continue paying for the family planning program.