No, South Carolina does not pay for abortions. Why some state lawmakers think it does

A South Carolina House member is claiming the Palmetto State is paying for abortions. He’s not the first to do so.

But the point raised by state Rep. Jordan Pace, R-Berkeley, and other Republican representatives, contradicts a prohibition of using federal money for any abortion services and state law. What is their contention?

Pace, chair of the House Freedom Caucus, tweeted recently that “abortion clinics” are receiving money from the state through family planning dollars. The tweet was a multipost thread targeting medical waste barrels coming out of a women’s clinic.

The tweet, which garnered more than 16,000 views read “... SC shouldn’t be subsidizing the death & sterile desecration of the little children. Sadly, abortion clinics themselves are still receiving funding directly from the state via ‘family planning,’ dollars.”

People who don’t yet qualify for Medicaid, but work low-wage jobs where the employer doesn’t provide insurance receive family planning money, which come from the federal government and are given to each state. Some states, including South Carolina, add money to this fund.

The South Carolina Department of Health and Human Services says family planning services “prevent or delay pregnancies and do not include abortion or abortion-related services,” according to Jeff Leieritz, director of strategic communications for HHS.

In line with current federal and state laws, family planning services “generally prohibit the use of taxpayer funds to provide abortion-related services,” Leieritz wrote via email.

During the 2022-23 fiscal year HHS reimbursed health care providers approximately $35 million for family planning services, including services related to pregnancy prevention, coverage of contraceptives, hysterectomies, vasectomies, preventive physical examinations, health and cancer screenings and other non-abortion-related services, Leieritz wrote.

Leieritz wrote that Medicaid uses a mix of federal and state money to pay for services. South Carolina pays for about 30% of the cost, with the federal government picking up 70% of the cost.

Because family planning services are mandatory services through the Social Security Act, they must be covered to draw down federal matching funds used to provide health care services through the state’s Medicaid program. Not providing a mandatory service through a state Medicaid program could prevent a state Medicaid agency from receiving federal matching funds, Leieritz explained.

In 2023, South Carolina received $5.4 billion in federal matching money for health care services provided through the state’s Medicaid program, Leieritz wrote.

Vicki Ringer, Planned Parenthood South Atlantic director of public affairs, said the nonprofit doesn’t receive any family planning money. Ringer said they provide care to anyone, regardless of whether they are able to pay, through donations they receive.

The only money that could be considered coming from the state would be Medicaid reimbursements or through the state health plan and would pay for services such as annual pap-smears to vasectomies or contraceptive refills, but they can not be abortion services, Ringer said.

“Medicaid, nor the state health plan, has never paid Planned Parenthood for an abortion,” Ringer said.

State Rep. Josiah Magnuson, R-Spartanburg, who is a vice chair in the state Freedom Caucus, proposed an amendment during the 2023-24 legislative session to end the state matching federal family planning funds. Republican lawmakers have put forth similar amendments in past sessions, claiming the money is the state’s way of funding abortions, and it needed to stop.

“The state has to match federal HHS family planning dollars,” Pace said. “The federal rules say you can’t discriminate. If you give it to one group, you can’t say groups that also provide abortion can’t have this money. So Josiah’s solution was, I voted for it, too, to just not match that federal money, so that South Carolina tax dollars no longer go to abortion.”

However, the federal money funds given to states for family planning can not be used for abortion services under the Hyde amendment with three exceptions: where a pregnancy is the result of rape or incest, or where it puts the life of the mother in danger.

Federal law requires state Medicaid programs to cover abortion-related services for cases within these three exceptions, Leieritz said. South Carolina’s Fetal Heartbeat law contains the same exceptions. Services provided under these exceptions are not considered a family planning service, but would instead a medical service.

Leieritz said providers who perform abortion services outside of the three exceptions laid out in federal and state law will not receive Medicaid funds.

“In support of this principle, and in response to Governor McMaster’s Executive Order 2018-21, SCDHHS sent a letter terminating Planned Parenthood South Atlantic from the state’s Medicaid program effective July 13, 2018,” Leieritz wrote.

He said his department asked the U.S. Supreme Court to take up its case, Kerr v. Edwards, earlier this year.

Tweet for truth or attention

While Republicans have fought against family planning funds for years, Pace’s tweet also made claims about the disposal of babies being “butchered in the womb at the murder mill.”

But Ringer said at six weeks, which is the abortion ban under South Carolina law, there is no developed fetus, it’s an embryo, which is generally invisible to the naked eye, she said.

“The most that you would be able to see with those abortions is a small amount of blood,” Ringer said.

Attached to the post were two photos, one of a man hauling a blue medical waste barrel outside a building and another of a white vehicle belonging to a medical waste company, Advanced Environmental Options. Pace said the photos were take outside the women’s clinic in Charleston.

Pace said the photos in the tweet were given to him by someone who “prays for women heading into” the abortion centers. He said there’s at least a dozen people who go out daily in front of the centers. South Carolina has three medical clinics that provide abortions.

Pace also wrote that the company, AEO, receives dollars from taxpayers. AEO is an environmental company that “utilizes strategies for waste reduction, recycling, reuse, destruction and treatment rather than long-term disposal whenever possible,” according to its website.

AEO spokesperson Vince Goldner, said the company does have a contract through the Department of Health and Environmental Control for specific jobs. The state’s accountability website also show it contracts with other state agencies for cleanup services.

Goldner said the company handles waste from Planned Parenthood centers and ensures it goes to the proper waste facilities. He said 95% of the medical waste they deal with is “sharps” — items like needles.

DHEC does not pay for anything for Planned Parenthood, Ringer said. Planned Parenthood pays for its own services, she said but would not confirm what company it uses for medical waste disposal.

Goldner added that anything that is used in any medical facility that has come in contact with the human body has to be sent to the incinerator.

Pace himself or the person who provided the photos to him could not confirm what was in the barrels.

“Obviously, nobody looked in the barrel. But the only thing, the only bio waste that comes from that clinic, the only procedures that are done in that clinic are abortions,” Pace said.

Ringer, however, said women’s clinics perform lots of procedures that produce medical waste.would need medical waste disposal used in women’s clinics.

“Needles are medical waste, anything that could be the carrier of some type of biological fluids, germs, diseases. Generally, everything that is in a medical clinic would be medical waste,” Ringer said.