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S.C. bill would let health care providers refuse non-emergency care based on beliefs

[POST-BROADCAST CORRECTION: In this report, we incorrectly refer to Ivy Hill by the pronoun “she.” Hill uses the pronoun “they.”]

ARI SHAPIRO (HOST): South Carolina has passed a controversial new bill. It says all medical practitioners and health care institutions, including doctors, pharmacists and insurance companies, can refuse to provide nonemergency care that conflicts with their beliefs. The governor is expected to sign it. Supporters say health care professionals should not be forced to violate their conscience. Critics say it's a license to discriminate, especially against LGBTQ people. South Carolina Public Radio's Victoria Hansen reports.

VICTORIA HANSEN (BYLINE): Amberlyn Boiter worries doctors now have a legal excuse to deny her health care. She is a transgender woman who lives in South Carolina.

AMBERLYN BOITER (SOUTH CAROLINA RESIDENT): I haven't even felt comfortable going to a doctor in well over a year.

HANSEN: That's when she began transitioning to the woman she feels she was meant to be, and doctors would not prescribe the gender-affirming hormone therapy she needed. Boiter bought them online and found an out-of-state doctor she sees via telehealth. It's care, she says, most of her transgender friends can't afford.

BOITER: The truth is it's dangerous for a lot of trans people out there who don't have access to mainstream health care.

HANSEN: Boiter fears this bill will make it worse.


LARRY GROOMS (R-SC, SEN): This is America, where you should have the freedom to say no to something that you don't believe in.

HANSEN: Republican Senator Larry Grooms championed the Medical Ethics and Diversity Act. In addition to saying no to gender-affirming care, the act gives medical practitioners the freedom to refuse any service they object to morally, from a physical exam to prescribing medication. Groom (ph) insists the bill does not discriminate because...


GROOMS: This act - it is based on procedure, not on patients.

HANSEN: But Ivy Hill with the LGBTQ rights group Campaign for Southern Equality says you can't separate the person from the medical procedure they need.

IVY HILL (CAMPAIGN FOR SOUTHERN EQUALITY): It is absolutely targeting people.

HANSEN: And she says the bill adds another barrier to medical care that's already scarce for LGBTQ people, especially in rural South Carolina. Dr. Alex Duvall practices family medicine along the coast. He's Christian and wrote to lawmakers to support the bill.

ALEX DUVALL (PHYSICIAN): Anything that is considered immoral behavior, I can't condone, or I can't help them participate in it.

HANSEN: Like, he says, giving hormone therapy to transgender patients. He's relieved the bill would protect him.

DUVALL: This is about all conscience, but it doesn't mean you don't care about patients and love patients and want to do your best for them.

HANSEN: The bill states that the, quote, "right of conscience is a fundamental and unalienable right." But Allen Chaney, with the ACLU of South Carolina, says discrimination is discrimination.

ALLEN CHANEY (ACLU OF SOUTH CAROLINA): And stating that your conscience compels your discrimination doesn't make it lawful.

HANSEN: He expects the bill to be challenged because discrimination based on sexual orientation and gender identity is prohibited. Meanwhile, a group of 50 South Carolina medical practitioners asked the governor to veto the bill. Dr. Elizabeth Mack, the American Academy of Pediatrics spokesperson who testified against the bill, says health care should be based on science.

ELIZABETH MACK (SPOKESPERSON, AMERICAN ACADEMY OF PEDIATRICS): And the evidence supports, you know, gender-affirming care, supports dignified end-of-life care, supports contraception. We might think that these things are controversial or what have you, but the evidence is really supportive.

HANSEN: For some, like Amberlyn Boiter, the care doctors can refuse under the bill means life or death. She says not getting gender-affirming hormone therapy...

BOITER: I know beyond any shadow of a doubt that that would kill me.

HANSEN: She still wants to find a doctor to see in person, not online. But she's hesitant - being refused care legally could be too painful. For NPR News, I'm Victoria Hansen in Charleston, S.C.


Victoria Hansen is our Lowcountry connection covering the Charleston community, a city she knows well. She grew up in newspaper newsrooms and has worked as a broadcast journalist for more than 20 years. Her first reporting job brought her to Charleston where she covered local and national stories like the Susan Smith murder trial and the arrival of the Citadel’s first female cadet.