Healthcare Access in SC

Healthcare Access in SC

The League of Women Voters believes that all South Carolinians should have affordable access to a basic level of quality health care that includes behavioral health care and reproductive health care, but the reality is that this remains out of reach for many. We believe that SC should participate in federal programs to provide health care insurance and services for all South Carolinians.

By the numbers…

What percentage of adult South Carolinians are uninsured? 
In 2024, 13.2% of the adult population 19-64 was uninsured in SC - over 400,000 people. However, this percentage is likely to increase significantly to 16% where it was in 2019. Pandemic legislation and the Inflation Reduction Act provided enhanced premium tax credits on the insurance market exchange so that people whose incomes were below 150% of the federal poverty level paid almost no premium for good coverage. In the past few years SC's exchange-covered population grew by over 400,000 people. The enhanced tax credits, the focus of the recent government shutdown, expired in 2025 and projections are for almost 200,000 adults on the exchange in SC to become uninsured. 
 
Who are the uninsured in South Carolina?
Among uninsured in South Carolina, 87% are aged 19-64. 55.5% are male. 51.5% are white.
 
How many people in South Carolina are on Medicaid?
About 18% of the population were on Medicaid with full benefits as of July 2025; that's about one million people. An additional 240,000 people qualify for limited benefits such as family planning coverage. 
 
Most of those with Medicaid are children, people with disabilities, or seniors in long-term care. Only 170,000 adults 18-64 have full Medicaid coverage. 
 
What is eligibility for working age adults on Medicaid?  
 
In 2026, only parents with incomes below $18,304 (3-person family) are eligible for Medicaid.  Women who are pregnant or 12 months postpartum also have coverage at higher income eligibility. 
 
If SC expanded Medicaid coverage under the Affordable Care Act, what is working age adult eligibility? 
With eligibility expansion, all adults who meet work or school requirements or are exempted due to medical frailty or dependent child care would qualify if their incomes are less than $37,702 (3-person family)  
 
If SC expanded Medicaid, how many more working age adults would have access to health insurance? 
246,000 working age adults. (Note: This estimate is rough, because the recently passed HR 1, known as "One Big Beautiful Bill," imposed work requirements for expanded Medicaid eligibility and the impact is uncertain) 
 
 
Status of State Medicaid Expansion Decisions
 
 
Source: Kaiser Family Foundation

 

Recommended Reading

Sources
South Carolina Legal Services Federal Poverty Guidelines: https://sclegal.org/income-guidelines/

 

Past Events 

Intersection of Mental Healthcare and Criminal Justice, April 2023

Intersection of Mental Health Care and Criminal Justice, event graphic

This program was part of our LWV Connects series, resulting from a collaboration between the League's Health Policy and Criminal Justice Committees. You can watch the recording here or view the slides here. 

Expanding Healthcare Access in South Carolina, March 2022

In Part 1 of this series we 1) provided historical context to health insurance access in SC, 2) described other states' experiences with expanding Medicaid, 3) focused on economic incentives of federal policies to increase healthcare coverage in SC, and 4) shared public opinion about increasing healthcare access in SC. Watch the recording here and click the image below for slides.

Health care slides

Expanding Healthcare Access in South Carolina, Part 2 

In the second session of this Healthcare Access series we (1) took a deep dive into misinformation and misconceptions about public health insurance (e.g., Medicaid), (2) addressed rhetoric concerning healthcare access in SC, and (3) gave a Call to Action where we provided talking points and facts that you could be shared with your networks to keep the conversation going. Click here for slides from Part 2 and watch the recording here. 

 

Issues: 
Health Care Reform
Health Care