ORANGEBURG, S.C. — After years of hard work, Ashley Myers finally realized her dream of owning a women’s fashion store and a beauty shop directly across the street from each other in this small, predominantly black city. But as the costs of her health care plan rose a year ago, she could only keep one storefront open.

Today, as the owner and the sole employee of the combined beauty shop and fashion store, she pays $800 a month for her health insurance premiums, but she said it really only helps in dire circumstances. Otherwise, she pays so much out of pocket that she feels as well off as her uninsured brother, who only sees a doctor in the emergency room, where he racks up huge medical bills.

“I try to be smart about when I go to the doctor and make sure I have the money or else they take it away from my business,” Myers, 35, said.

For many in this city of 13,000, health care and insurance are the foremost issues ahead of Saturday’s Democratic primary, when South Carolina voters will likely weigh the medical plans proposed by the different presidential candidates. Bernie Sanders' proposal of "Medicare for All" is beginning to appeal to some like Myers, who are worried about their own pocketbooks or concerned for family and friends who don't have insurance.

Ashley Myers, 35, in her beauty store on Main Street in Orangeburg, S.C. Mark Makela / for NBC News

“I just went to the doctor yesterday for a checkup and had to pay $100 just to be seen, and I still have to pay for the labs,” Myers said from behind the store’s counter, saying that she plans to vote for Sanders, I-Vt., on Saturday because he supports Medicare for All. “When I go in, it’s always at least $350, and it’s that much for my kids. At a certain point, it’s like, 'Why am I paying for this?'”

Health care is deeply personal to many in South Carolina, which boasts the second highest medical debt rate in the country at 32.8 percent, according to a 2017 study by the Urban Institute. Further research by the public policy think tank found that the median for medical debt in collections for state residents is $787.

Jaime Harrison, the Democratic candidate who appears poised to give Sen. Lindsey Graham, R-S.C., the most difficult challenge of his Senate career, said that health care is the No. 1 issue for voters in the state. Graham introduced legislation to repeal and replace the Affordable Care Act and weaken the Medicaid program in 2017, and Harrison hopes to beat him by addressing the insurance coverage needs of his state.

It’s an issue in South Carolina that stretches across the aisle, Harrison said.

“These are everyday people,” Harrison explained. “They aren’t Democrats and Republicans, they’re not black or white — they’re everybody. We have to figure this out. There is an important federal role in this process. We need to figure it out in a way that is not partisan.”

Many of the state's health care woes can be traced back to that political wrangling.