COLUMBIA, S.C. (AP) — The Legislature's only emergency room doctor said Thursday that frustration over Republicans' steadfast refusal to accept Medicaid expansion under the federal health care law led to a flippant comment that some are calling racist but he says was taken out of context.
Republican Rep. Kris Crawford said he was telling a group of doctors the fight over Medicaid was a political one. He said his comment that "it is good politics to oppose the black guy in the White House" was not meant to be racial, but wrapped up his explanation that the vote is not over policy.
"I was making an observation to them that what's going on here is a political debate about entitlements in America, not what they want to talk about, which is health policy," Crawford, R-Florence, said, referring to his question-and-answer session with doctors who came to the Statehouse to lobby for expansion.
"Washington's pushing for 'yes.' The governor's saying absolutely 'no.' I was trying to relate to the dichotomy of the decision," he said. "It's an on-or-off decision, black or white. I was probably more flip than I should've been."
The comment was published in a business journal in January but didn't get much notice until this week, when the House rejected Democrats' attempts to insert Medicaid expansion into the budget. Despite hours of Democrats' pleading, the votes fell along party lines, with no Republican crossing over.
The article said Crawford supports Medicaid expansion but expected his party would vote as a block against it.
"The politics are going to overwhelm the policy. It is good politics to oppose the black guy in the White House right now, especially for the Republican Party," read Crawford's quote in the Jan. 29 article.
After political operatives drew attention to the quote this week, Gov. Nikki Haley weighed in Thursday, calling Crawford's comment ignorant.
It "in no way represents the people of South Carolina, and it's a shame that the views of a few end up damaging the image of our state as a whole," said Haley spokesman Rob Godfrey.
Democratic Party Chairman Dick Harpootlian called Crawford's statement racist and inexcusable, and said Haley's response "reads a lot like the pot speaking to the kettle."
But the chamber's chief Democrat found no fault in Crawford's assessment of GOP politics.
House Minority Leader Todd Rutherford, who is black, said Crawford was merely telling the truth. He said if he had read that quote from someone else, he might think otherwise.
"Obama is black and lives in the White House. I think he was stating the obvious," said Rutherford, D-Columbia. But Republicans might not like it, he said, since "it's exposing what you're doing."
"Unfortunately, he voted against it, but his vote would not have changed a thing," Rutherford said.
Crawford said he had no problems with voting down the Democrats' proposals, largely because he believes finding a long-term solution for covering more poor adults should be handled in a separate measure, not in the budget, which is a one-year law.
He said his frustration with his Republican colleagues was their "no, no, no" attitude, adopting Haley's stance of refusal without seeking alternatives.
His fellow Republicans say that's not true.
They point to initiatives in the budget intended to improve health while lowering costs. The programs, funded through savings realized over the last year, are intended to increase access to health care in rural areas, as well as steer people away from hospital emergency rooms statewide and toward primary care in free or low-cost health clinics.
"What we did was say, 'We need to look at ways to improve Medicaid and bring down the costs,'" said Rep. Murrell Smith, whose subcommittee writes the health care budget.
Medicaid is the fastest growing section of the budget. The current system is projected to cost an additional $2.4 billion in state revenue through 2020.
"We've got a system now we can't control," said Smith, R-Sumter. "We came up with options to control the cost and try to strengthen safety nets for those who don't have insurance."
During floor debate, Democrats gave Republicans credit for the initiatives, but said they're no substitute for extending coverage to hundreds of thousands of poor adults.
Crawford said he intends to file a bill next month that would put the budget initiatives into state law and explore other ways to provide health insurance to those who get de facto coverage through hospital ERs.
Medicaid director Tony Keck said he doesn't need a separate law to enact the initiatives.
"They're not authorizing one-time money. They're directing the department to go ahead and implement a series of strategies," Keck said, saying the savings will continue to fund them. "We can continue to do that without legislative action."