SC health plan bans on birth control for employees’ daughters. That could change. | Palmetto Policy
COLUMBIA – Some South Carolina lawmakers are considering their own health plan as the next step in curbing unwanted pregnancies that can end in abortion.
The health insurance plan for more than 500,000 South Carolina residents, which is tied to the public sector, specifically prohibits birth control coverage for employees’ children.
This presents an unnecessary obstacle to young women trying to take on responsibilities with parental support, said Dr. Kristl Tomlin, a gynecologist specializing in adolescent gynecology, told senators this month.
“That means your college student…isn’t covered under this plan, the largest in the state, and I encounter that barrier every day in my office,” the Columbia specialist said, pointing to a state health plan policy screen .
“It’s a kind of travesty,” she told members of the Medical Affairs Committee.
Her testimony, made during a nearly nine-hour hearing on the state’s ban on abortion, renewed efforts to make contraceptives more accessible in a bid to reduce early abortions, Senator Tom Davis told The Post and Courier.
The Beaufort Republican was the main sponsor of a bill signed three months ago that would make birth control pills and other hormonal contraceptives available in pharmacies without a prescription. But it wasn’t about the insurance. And it does not apply to young people under the age of 18.
Next could be changing state health plan policy, Davis and other senators from both parties said.
The State Health Plan provides coverage for families of employees of all state agencies and public colleges, as well as school districts and local governments throughout South Carolina. Her covered dependents include about 26,300 daughters ages 15 to 25, according to the Public Employee Benefit Authority, which oversees the plan.
The agency estimates that it would cost $3.2 million to fully cover the cost of its contraceptives, as the plan has done for employees and their spouses since 2017, when lawmakers first included a clause in the state budget has that requires this.
More than 9,200 daughters have partially taken over their contraceptives because their doctors prescribe them for reasons other than birth control. This derogation, granted through a prior authorization process, is being used more and more. Reasons covered include ovarian cysts, endometriosis and bleeding disorders, according to the agency.
The $3.2 million price includes full payment for her prescriptions and coverage for an estimated 5,900 daughters who would be new to the offering.
Sen. Margie Bright Matthews, D-Walterboro, said she expects many more to do so. The testimony didn’t surprise her at all, she said, because voters had been complaining to her about it for years.
Regardless of the cost, South Carolina shouldn’t limit access to both abortion and contraception at the same time, she said, noting that the parents of these daughters pay for health insurance out of their paychecks.
“We’re going to choose the types of coverage that we offer to the same young girls that we want to make sure they can’t have safe abortions?” she said. “I find that so disingenuous.”
A health plan policy change requires approval through the budget process because money is involved. According to a PEBA spokeswoman, the 11-member board, which includes three women, cannot make the change alone.
Senators tried it in 2017. In addition to the clause providing full contraceptive coverage for employees and spouses, the senators’ budget as of January 2018 included a separate clause mandating the same for dependents. The House of Representatives initially approved it as part of the compromise sent to Governor Henry McMaster’s desk.
McMaster vetoed this policy, calling it an unfunded mandate. The House of Representatives supported the governor’s motion and removed it from the budget.
Then-Rep. James Smith, D-Columbia, pleaded for an annulment.
“The implications are quite severe when it comes to loved ones, particularly students at school and cost savings from adequate access to contraception,” said Smith, who unsuccessfully challenged McMaster in 2018. “It seems pretty reasonable that we would do that. It seems to me that this is more of a political shot than a good move with financial responsibility.”
But the 58-54 vote fell short of the necessary two-thirds as not enough Republicans aligned with Democrats to overrule.
Ways and Means chair at the time, Brian White, said among Republicans who voted “no” that he had heard from many voters who opposed the reporting without saying why.
The legislature has not addressed the issue since then.
McMaster spokesman Brian Symmes said the governor’s reasoning was solely what he wrote in his veto message.
“It was an unfunded mandate, which is an irresponsible way of funding government programs without a sustained stream of funding to ensure the program’s success and longevity,” he told The Post and Courier.
He cited the law McMaster signed into law in May to make over-the-counter birth control available to women ages 18 and older and a $1.9 million earmarking to the New Morning Foundation, which he did not veto. as evidence of the governor’s support for making contraceptives more accessible. This was followed by a $750,000 donation 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.
Unwanted pregnancies cost taxpayers up to $79 million annually in publicly funded births, newborn and postpartum care, according to the New Morning funding proposal presented to McMaster as he debated which budget items to veto.
Symmes reiterated what McMaster said in May: “If South Carolina is going to be a pro-life state, we need to provide the resources to prevent unwanted pregnancies.” But Symmes didn’t answer whether that meant McMaster was giving birth control to the daughters of employees ages 15 to 25 if lawmakers tried again and risked $3.2 million to pay for it.
Senate Minority Leader Brad Hutto, D-Orangeburg, said the unspoken opposition to the budget directive inserted at his request in 2017 was because Republicans didn’t want to be blown up for offering birth control to teens in one state , in which only abstinence remains the standard sex education in schools.
“I’m glad the issue has come up again,” Hutto said, promising to reintroduce the proposal. “I will make sure that we discuss this more openly than in the past.”
The implementation of the law signed by McMaster in May is still a work in progress. State regulatory agencies for pharmacists and coroners, who have been given up to six months to draft rules for pharmacists who wish to participate, are accepting written public comments on the protocols until August 29.
The joint protocol committee has tentatively scheduled a meeting for two days later, a spokeswoman for the Department of Labour, Licensing and Regulation said.
If that’s the case, they’ll likely meet while the whole House debates legislation banning abortion except to save the mother’s life or prevent a serious, lifelong health problem. Senators return to Columbia on September 6 to change whatever the House of Representatives is proposing.