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 and can receive revenue from various sources, including state appropriations and private donations. The Department of Health and Human Services (DHHS) will manage the fund and provide annual reports on its usage and projections. Additionally, the act mandates the full expansion of Medicaid eligibility under the federal Affordable Care Act, allowing individuals earning up to 138% of the federal poverty level to qualify, and requires the DHHS to develop an enrollment plan and fiscal impact report within specified timeframes.

Furthermore, the act emphasizes collaboration between the DHHS and various stakeholders, including hospital systems and health centers, to conduct biannual assessments of Medicaid's impact on coverage gaps, uncompensated care costs, and regional health outcomes. These assessments will also evaluate the economic effects of Medicaid expenditures on local economies and workforce needs for service providers. The findings from these assessments will be reported to the General Assembly every two years, starting July 1, 2026. The act will take effect upon the Governor's approval.