COLUMBIA, S.C. – In the final days leading up to the South Carolina and Super Tuesday Democratic primaries, candidates on Friday sought to bolster support across the South and the West. The South Carolina primary election has consistently reflected the winner of the general Democratic primary for years, and this year is no different for South Carolina natives.

Regardless of which candidate they support, the top priority for many is health care.

Voters from both South and North Carolina traveled to cheer on the candidate they thought would improve the cost and availability of health care the most.

A rally Friday for Democratic presidential candidate Sen. Bernie Sanders, D-Vt., drew hundreds of supporters on the eve of the state’s primary vote in Columbia, South Carolina. A central issue that drew many of the voters was lack of access to affordable health care.

Sanders is running his presidential campaign on his Medicare for All plan, which would completely eliminate private health insurance and create a government-run plan for all U.S. citizens funded by taxes.

Lisa Collins, a retired public school teacher from Columbia, said she has seen firsthand the effect of no health insurance on children, which has likely locked in her vote for Sanders.

“It is unconscionable that people in this country don’t have access to free health care,” Collins said, and “it is getting worse for families.” Children lose teeth at young ages and cry during class because their teeth hurt, but their parents don’t have access to dental insurance, Collins said.

One first grader went deaf in one ear because she had an ear infection, but her parents couldn’t afford to take her to the doctor, even though they both worked as bus drivers.

“If you lose your job, or can only find a job that is less than 40 hours a week, you don’t have health insurance,” Collins said.

Deidra Cos and Casper Cilia, young voters from Asheville, North Carolina, drove 2½ hours for the Sanders rally.

“I grew up around a lot of people that didn’t have access to health care, and people in my family didn’t have health care,” Cos said. She said she agrees with all of his policies, not just Medicare for All.

As rural hospital closures become more common, and the price of care increases, many are left without health care. The same health care cost and access issues resonate in Southwest Colorado.

Of the 40 rural hospitals in Colorado, 18 are operating at a negative profit rate, according to the Colorado Rural Health Center. With 13% of Southwest Coloradans living below the federal poverty line, the 11 rural hospitals in the area are providing critical care, said Kelly Erv, policy and advocacy manager of the center.

“You can’t have a community without a rural hospital, you can’t raise children there,” Erv told The Durango Herald in a phone interview.

And with a multimillion-dollar industry in skiing, hiking and mountain climbing tourism, access to health care is necessary to keep those activities worthwhile for customers, Erv said.

In a packed community gym, former mayor of South Bend, Indiana, Pete Buttigieg fielded questions from an enthusiastic audience.

Avanish Madhavaran, a student from the University of North Carolina, traveled to Columbia for the town hall. He works for Students for Pete on UNC’s campus, and said Buttigieg would bring needed structural change.

Madhavaran listed rural medicine, telemedicine and broadband expansion as reasons for supporting Buttigieg.

“Pete would provide money to rural hospitals and broadband in rural areas,” Madhavaran said.

A surrogate, or representative, for Buttigieg at Hammond Grove Baptist Church in North Augusta also talked about rural telehealth and broadband as something Buttigieg could provide for the community.

“Those are the things that impact us in South Carolina,” surrogate Janet Evelyn said.

Mike Schmuhl, Buttigieg’s campaign manager, said in an interview with the Herald that when it comes to issues like health care, “you can be progressive together, and you can move the ball on a lot of things but still bring people together.” Opposed to Medicare for All, Buttigieg would allow people to keep their private insurance while making a government plan available for those who want or need it.

Donna Huddleston, a voter from Columbia and a Buttigieg supporter, said she is voting in the Democratic primary on Saturday because doctors “honestly didn’t think she would make it to November.”

But watching videos of Buttigieg “makes her blood sugar go down,” Huddleston said. “He is calm and collected, the way presidents used to be.”

Buttigieg was in Aurora on Feb. 22 to raise support before Colorado’s Super Tuesday election.

Schmuhl said Buttigieg is doing well in rural areas because the campaign is doing “warm outreach as opposed to cold outreach to voters.”

Emily Hayes is a graduate student at American University in Washington, D.C., and an intern for The Durango Herald.