The "South Carolina Medicaid Protection and Expansion Act" aims to enhance the state's Medicaid program by establishing a "Medicaid Stability Fund" to counteract potential reductions in federal funding. This fund will be exclusively used to support Medicaid-eligible populations in South Carolina and will be financed through state appropriations, budget surpluses, reallocated funds, and donations. The Department of Health and Human Services (DHHS) will oversee the fund and provide annual reports on its usage and projections. Additionally, the act mandates the full expansion of Medicaid eligibility under the federal Patient Protection and Affordable Care Act, allowing individuals earning up to 138% of the federal poverty level to qualify for Medicaid. The DHHS is required to develop an enrollment plan and fiscal impact report within 90 days of the act's effective date.

Furthermore, the act emphasizes collaboration between the DHHS and various stakeholders, including licensed hospital systems and health centers, to conduct biannual assessments of Medicaid's impact on coverage gaps, uncompensated care costs, regional health outcomes, and local economies. These assessments will help identify workforce needs for Medicaid service providers and will be reported to the General Assembly every two years starting July 1, 2026. The act will take effect upon the Governor's approval, ensuring that any unconstitutional provisions do not affect the validity of the remaining sections.