Seventeen new Republican lawmakers, almost a fifth of the large House GOP freshman class, have rejected federal medical coverage for themselves and their families to highlight their opposition to President Barack Obama's showcase health-insurance law.
South Carolina's four rookie congressmen are not following their lead.
U.S. Reps. Mick Mulvaney, Tim Scott, Trey Gowdy and Jeff Duncan voted last month to repeal what they and their Republican colleagues call "ObamaCare," the landmark bill the president signed into law last March to provide federally mandated coverage to 32 million uninsured Americans.
But the state's four freshman representatives aren't repealing their own new memberships in the Federal Employees Health Benefit Program, a heavily taxpayer-subsidized plan with broad choices, generous provisions and low premiums thanks to discounted rates for its 8 million policyholders nationwide.
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Mulvaney, an Indian Land Republican, worked as a lawyer and residential developer before serving a term in the S.C. Senate and then defeating U.S. House Budget Committee chairman John Spratt, D-York, in November.
Mulvaney said medical coverage for himself and his family now costs him more than it did when he was a state senator.
"I am paying for the same health insurance plan that thousands of other federal employees get," he said. "That has nothing to do with opposing ObamaCare - which is a massive health-insurance takeover."
Norman Ornstein, an analyst with the conservative American Enterprise Institute in Washington, thinks there is a gap between the talk and the walk of lawmakers who oppose "the federal takeover of healthcare" while accepting federal medical benefits.
"The amount of hypocrisy here is obviously very high for people who talk about how we all have to make sacrifices but don't make any sacrifices themselves," Ornstein said. "They talk about how the health-care system is out of control, but then they take these very generous benefits they get as members of Congress."
South Carolina is one of only eight states with at least four GOP rookie representatives, new members of Congress who face a decision about whether or not to take federal health insurance. Tennessee is the only other one of those states in which none of the GOP freshman lawmakers have turned down federal health insurance.
Three of Illinois' five new House members refused to sign up. So did three of Florida's eight freshman lawmakers.
"I have term-limited myself," U.S. Rep. Bobby Schilling, an Illinois Republican, told ABC News. "I am not taking the pension. I am not taking pay raises, and my family and I are bringing our own health care to Washington, D.C."
At a House Rules Committee hearing last month, the day after he was sworn into Congress for first time, U.S. Rep. Richard Nugent, R-Fla., explained why he was declining the federal medical benefits to which he was entitled.
"When you have Americans that are struggling, why should I get a cost savings because I've just got elected to the United States House of Representatives?" Nugent asked.
Nugent, a former sheriff, said he is paying about $750 a month more to cover himself and his family rather than pay the roughly $450-a-month premium he would have paid under the federal coverage offered a congressman.
South Carolina's four Republican freshmen, all of whom held state or local elective office before coming to Washington, aren't able or willing to bear the extra cost.
None think they should have to pay more for their federal coverage than they now are paying. Seventy-two percent of the federal health-care plan's costs are paid for by U.S. taxpayers, not the insured, according to the Office of Personnel Management.
"Like millions of other Americans, I receive health insurance through my employer," said Duncan, a Laurens Republican who served four terms in the S.C. House and owned an auction house before his election to Congress.
"Unfortunately, the health-care bill, commonly referred to as ObamaCare, is making it more difficult for employers to provide insurance to their employees," he said. "It limits individuals' ability to pick their own doctors and over time decreases the quality of care we provide in this country."
Gowdy, a Spartanburg Republican who defeated incumbent U.S. Rep. Bob Inglis last year in the Upstate's GOP primary, said he now has the same health coverage he had from 1994 to 2000 when he was a federal prosecutor in the U.S. Attorney's Office in Greenville.
"The way our health insurance is set up in this country is - you receive health insurance from your employer," Gowdy said.
Gowdy said he chose to go on the federal health plan instead of using state-government coverage provided to his wife and their two children through her job as a Spartanburg public schools teacher's aide.
"It may have scored political points for me to tell everyone I turned down my federal health insurance, but it seems disingenuous and would have added to the South Carolina rolls someone who has employment elsewhere," he said.
However solid it may be, that kind of reasoning could extract a political price.
Only a third of Americans think new House members who campaigned against Obama's health insurance law should accept their federal medical coverage, according to a survey last November by Public Policy Polling, a Democratic-affiliated firm in Raleigh, N.C.
Fifty-two percent of Americans think the GOP freshmen lawmakers should reject the federal benefits, while 15 percent have no opinion.
Republican and independent voters had even stronger feelings, with 58 percent saying their party's new House members should turn down the medical coverage.
Scott, a North Charleston Republican who represents the GOP freshman class in House leadership sessions, said he paid for part of his employees' health-care costs when he owned an Allstate insurance firm in South Carolina.
"If I did not work in Congress, I would not want the federal government paying for a portion of my health care," Scott said. "I support employer-sponsored health plans, as this has been the vehicle through which the majority of Americans have their coverage.
"I believe in market-based, patient-centric reform and do not believe government should take over health care," he said.