The "South Carolina Medicaid Protection and Expansion Act" aims to enhance the state's Medicaid program by establishing a Medicaid Stability Fund and fully adopting Medicaid expansion as outlined in the federal Patient Protection and Affordable Care Act. The fund, created within the State Treasury, will be dedicated to offsetting any reductions in federal Medicaid funding that affect South Carolina's Medicaid-eligible populations. It will receive revenue from various sources, including state appropriations, budget surpluses, and donations. The Department of Health and Human Services (DHHS) will manage the fund and provide annual reports on its usage and projections.

Additionally, the bill mandates the DHHS to expand Medicaid eligibility to individuals earning up to 138% of the federal poverty level and to access an enhanced federal match rate for new enrollees. The department is required to develop an enrollment plan and fiscal impact report within 90 days of the act's effective date. Furthermore, the DHHS will collaborate with hospitals, health centers, and universities to conduct biannual assessments of Medicaid's impact on coverage gaps, health outcomes, and local economies, with findings reported to the General Assembly every two years starting July 1, 2026.